Several factors can increase your chances of suffering from a stroke. Excess weight is one of them. It’s a risk factor because it increases the likelihood that you’ll have high blood pressure, type 2 diabetes, or heart disease. All three conditions are known to be associated with increased risk of stroke.
Not enough exercise
Of course, it’s not lack of exercise itself that may predispose you to suffering from a stroke. Instead, it’s what insufficient exercise means for your weight, blood pressure and general health. People who don’t reach the recommended weekly minimum exercise thresholds are more likely to be overweight, have high blood pressure, cholesterol, and suffer from heart disease.
As if you needed another reason to quit smoking, an increased risk of stroke is definitely on the list. Smoking’s many unhealthy side-effects include raised blood pressure, hardening of the arteries and “stickier” blood, which makes blood clots – and hence a heart attack or stroke – more likely.
High blood pressure
Whether it takes diet, exercise, medication or all three, reducing high blood pressure is well worth it. The potential benefits of taking action include reducing the likelihood of stroke. That’s because high blood pressure can place the arteries supplying blood to the brain under such pressure that they burst or become blocked. The result is a stroke.
Too much salt
If you’ve ever wondered what’s so very bad about salt, the most straightforward answer is that it is directly linked to a rise in blood pressure. High blood pressure is the precipitate for a range of potentially fatal conditions, including enlarged heart muscle, arterial hardening, heart failure, and stroke.
Another reason to lay off the saturated fats is your stroke risk profile. Excess cholesterol enters the blood stream and gets into the vessel walls, making them increasingly stiff. This rigidity increases the chance of a blood clot and, if a blood clot travels to the brain, it can cause a stroke.
Medics agree that diabetes is a risk factor for stroke. This is because diabetes often causes changes to the blood vessels. If cerebral vessels are affected, a stroke can result. Additionally, prognosis after a stroke is generally worse in diabetic patients, especially those with poorly-controlled blood glucose levels.
Atrial fibrillation is a common abnormal heart rhythm or arrhythmia, which feels a little like a fluttering in the chest. In atrial fibrillation, instead of the heart emptying itself of blood whenever it contracts, blood may pool inside the organ. A clot may form from this pooled blood and a stroke can result if that clot travels to the brain.
Facial numbness or weakness
Sudden facial numbness or weakness is a well-known warning sign of stroke. To the observer, it may look like the face is drooping. Although it typically affects one side of the face, a stroke can affect both sides. Facial drooping is normally seen in the lower part of the face unless the stroke is in the brainstem, in which case the forehead may be affected.
Slurred speech is another common warning sign that a stroke is imminent or has recently occurred. This speech impediment is usually a consequence of sudden facial numbness or weakness, which affects the ability of the muscles of the cheek, lips and tongue to form words.
Several conditions can cause sudden confusion. They include urinary tract infections (especially in elderly people), hypoglycemia (low blood sugar) in diabetics and “mini-strokes”. Properly called a Transient Ischemic Attack or “TIA”, this is a temporary disruption to the blood flow to the brain. It often precedes a full stroke.
A stroke may cause aphasia. This is a language disorder that affects communication. It’s the result of damage to the part of the brain that controls language – whether verbal or signed. Aphasia can be long-lasting although a speech therapist may be able to assist a sufferer regain some or all of their verbal or signed fluency.
Difficulty understanding speech
Even if they don’t at first realize it’s caused by a stroke, it’s usually easy for an onlooker to notice when someone’s speech changes drastically. However, it’s not always as immediately apparent if a stroke victim’s ability to understand speech is affected. If this happens, it’s usually caused by aphasia (damage to the brain’s language center).
Sudden eyesight problems
Strokes can damage the nerves that lead to the eyes. These problems can affect one or both eyes, and may apparently develop out of nowhere. Problems controlling eye movements are common. This can make it difficult to use the eyes as a pair, which, in turn, leads to blurred vision or difficulty focussing.
Dizziness has several potential causes. These include a sudden drop in blood pressure, low blood sugar, and heat exhaustion. However, a stroke can also cause dizziness if that stroke has affected the cerebellum or brainstem. That’s because these are the areas of the brain that control balance. Anything that adversely affects them is likely to precipitate dizziness or vertigo.
A stroke that affects the cerebellum or brainstem often causes balance problems. This isn’t because anything is wrong with the muscles themselves. Instead, the resulting limb ataxia (which literally means “without coordination”) is a consequence of damage to the movement and balance centers in the brain.
Stroke-induced damage to the brain’s balance and movement centers frequently results in characteristically clumsy movements. This can show itself as difficulty in walking – sometimes to the extent that a previously completely mobile person is unable to walk at all or requires support from a stick or another person.
Lack of coordination
The level of damage that a stroke can cause to the balance and movement centers in the brain varies according to the severity of the stroke. At one extreme, a stroke victim may be unable to walk. At another, they may experience a lack of coordination in their movements that is new to them.
A stroke-related headache can come from nowhere. It’s variously described as very severe, “blinding” or “the worst headache ever”, and is often incapacitating in its severity. Frequently, the area of the head affected relates directly to the area of the brain where the stroke has occurred.
Tingling sensations frequently occur in the immediate aftermath of a stroke – even a very mild one. And, in the event of a mild stroke, these tingling sensations can be one of the best clues as to what has just taken place. Most stroke-related tingling subsides over time.
Strokes can affect your sense of touch. This can manifest itself in different ways. For instance, hypoesthesia is feeling less sensitive to touch – and often manifests itself as numbness. If you have hypoesthesia as a result of a stroke you might be less conscious of a tight waistband or even a hot stove.
Mini-strokes often precede a “proper” stroke. Properly called a “transient ischemic attack” (TIA), mini-strokes may pass unnoticed. They’re the result of a temporary disruption to blood flow in the brain. This blockage usually resolves quickly, which is why the effects of a TIA are less severe than a stroke. However, prompt diagnosis and effective treatment can reduce your risk of a subsequent stroke.
Strokes don’t usually cause fainting. As a result, if you faint, you’re unlikely to be experiencing a stroke. However, there’s an exception to this general rule, and that’s when a stroke affects the specific blood vessels in the base of the brain. Known as a postural circulation stroke, it often causes fainting.
Seizures rarely occur either during or in the 30 months following a stroke. One study found that 5% of cases involved a single seizure and 7% went on to develop epilepsy. Although anti-seizure medication However, where seizures do occur, they are associated with an increased risk of mortality.
Sudden nausea is a relatively rare stroke symptom. Where it does occur, it’s usually associated with a hemorrhagic stroke. This is bleeding into the brain following the rupture of a blood vessel, which may happen as a result of an injury, high blood pressure or a burst aneurysm.
Hemorrhagic strokes sometimes have a relatively slow build-up. For instance, they might begin with a headache and nausea, before proceeding to vomiting. Sometimes, however, vomiting occurs at the outset. That said, it’s worth remembering that the combination of headache and vomiting is usually the result of another more common condition, such as migraines or influenza.
Strokes classically, although not universally, affect one side of the body. This can result in paralysis of either the left or the right side of the body (hemiplegia). Unfortunately, this is a relatively common outcome of a stroke but treatments are good and, with time, frequently effective at restoring movement.
The stroke acronym (F.A.S.T.) references the most common stroke symptoms. The first of these refers to the face and, specifically, to the drooping that’s commonly seen in a recent stroke victim. If you’re unsure about whether or not someone’s face is drooping, asking them to try and smile can provide an answer.
If a stroke affects the brain’s balance center, the affected person may stumble or bump into things. This can happen straightaway, but the problem may also persist into the recovery period. Of course, sudden stumbling isn’t necessarily a result of a stroke. A number of other conditions, such as labyrinthitis, also frequently cause movement problems.
A severe stroke can leave its victim unable to communicate or even unconscious. In the worst cases, the person may fall into a coma. This means that they have little or no awareness of their surroundings. Locked-in syndrome, where a person is conscious but unable to move or communicate, is much, much rarer.
Sagging or weak arm
It’s common for strokes to cause weakness in the muscles of the shoulder or arm. As a result, even someone who previously had full mobility may experience difficulty in raising their arm in the air. Typically, this will affect only one side of the body.
The blood clot or broken blood vessel that causes a stroke may also result in damage to the nervous system. If this happens, a stroke victim may drool saliva. Similarly, if they were eating or drinking when the stroke occurred, food or liquid may dribble out of the side of their mouth.
Fatigue has many causes. Rarely, it’s a symptom of stroke – particularly in women. If it occurs, it may occur alongside a headache and general mental confusion. Post-stroke fatigue is more common in both women and men. Acute fatigue usually settles after six months but around 40% of stroke convalescent patients will go on to experience chronic fatigue.
Another atypical symptom that’s more common in women, general weakness is a rare early warning sign of a stroke. Where it does occur, it may occur alongside fatigue, headache and confusion. Of course, weakness is most commonly seen after a stroke, during the recovery phase.
Sudden drowsiness is an unusual warning sign of a stroke but is seen sometimes, particularly in women. More persistent drowsiness between episodes of TIAs is more common and, if correctly identified, is a useful indicator of a forthcoming “proper” stroke. With correct treatment, TIAs do not necessarily need to lead to a full-blown stroke.
Cerebral vasculitis is inflammation of the small blood vessels of the brain and spinal cord. It’s a rare condition that has several potential causes but, untreated, the potential consequences are severe. They include loss of brain function and, ultimately, a stroke or series of strokes. Treatment includes steroids and, where aneurysms are involved, surgery.
Cerebral venous thrombosis
A cerebral venous thrombosis is a blood clot in the brain’s venous sinuses. It prevents blood draining freely from the brain and, as a result, often causes headaches. A stroke may also follow, especially if the clot completely blocks the blood vessel. Strokes caused by a cerebral venous thrombosis are rare, making up around 1% of all incidences of stroke.
Although a relatively common condition, sinusitis can very rarely lead to a stroke, particularly in children. Sufferers of chronic rhinosinusitis are considered most at risk. It’s also worth noting that sinusitis can (again, rarely) result in a number of neurological conditions, including meningitis, encephalitis, or a brain abscess.
Another common childhood complaint, tonsillitis also has potentially very serious repercussions if the infection spreads to the brain. More commonly, enlarged tonsils (and adenoids) can cause sleep apnoea, especially in children. In very rare cares, sleep apnoea is associated with neurological complications that include stroke.
Hematological disorders are conditions affecting the blood, including sickle cell anemia and polycythemia vera. Some MRI studies indicate that as many as 40% of children with sickle cell anemia have suffered at least one stroke, termed “silent strokes” because they cause no discernible symptoms or side effects. Blood transfusion therapy is the usual treatment for sickle cell patients.