Whatever the cause – ischaemic or haemorrhagic – the affected area of the brain can no longer function resulting in an inability to move one or more limbs on one side of the body, an inability to understand or formulate speech, or to see one side of the visual field.
It is important that stroke victims receive hospital treatment as soon as possible after the onset of symptoms as early intervention is critical in determining clinical outcome. An ischemic stroke is sometimes treated by thrombolysis using recombinant tissue plasminogen activator (rtPA), which breaks down the blood thrombus. In acute ischaemic stroke, there is evidence that rtPA if given three hours after symptom onset increases the risk of death in the short term but in the longer term has a beneficial effect. Use of rtPA is recommended by some medical authorities (e.g. American Heart Association) if given within three hours of onset of symptoms but others caution that there is insufficient data to support its use as a standard mode of therapy. Some haemorrhagic stroke patients benefit from neurosurgery.
A stroke constitutes a medical emergency and can lead to permanent neurological damage and death. Risk factors for stroke include age, high blood pressure, a history of previous strokes or transient ischaemic attacks, obesity, diabetes, high blood cholesterol and tobacco smoking. Tobacco smoking is the most important modifiable risk factor for stroke, although body weight and cardiovascular fitness are important factors.
The treatment of stroke survivors designed to recover lost function is termed stroke rehabilitation and involves a range of health professionals, including speech pathologists, physiotherapists and occupational therapists.
Prevention of reoccurrence may involve the use of antiplatelet drugs such as aspirin, control of blood pressure, and the use of statins.
Stroke is Australia’s second biggest killer after coronary heart disease and a leading cause of disability. 1 in 6 people will suffer a stroke in their lifetime.
In 2012, about 50,000 Australians suffered new or recurrent strokes – that is 1000 strokes every week or one stroke every 10 minutes – and over 420,000 people were living with the aftereffects of stroke, 30% of these below retirement age.
The prevalence of stroke in Australia is forecast to increase. It is predicted that over 700,000 Australia will be living with the effects of a stroke by 2032, two-thirds of who will suffer a permanent disability that impedes their ability to carry out activities of daily living.