Stroke

A stroke is what happens when the blood supply to part of the brain is cut off - it may be caused by a bleed or a clot and can affect people in different ways. Every year an estimated 150,000 people in the UK have a stroke - that’s one person every five minutes and it is the third most common cause of death. Most victims are over 65, but anyone can have a stroke, including children and babies.

A stroke is sudden and the effects on the body are immediate. Without a blood supply, brain cells can be damaged or destroyed and won’t be able to do their job which will affect body functions. For example, if a stroke damages the part of the brain that controls how limbs move, limb movement will be affected. The brain also controls how we think, learn, feel and communicate. A stroke can also affect these mental processes.

There are two main causes of stroke

• The most common type of stroke is a blockage. This is called an ischaemic stroke, which happens when a clot blocks an artery that carries blood to the brain. It may be caused by a cerebral thrombosis, when a blood clot (thrombus) forms in a main artery to the brain; a cerebral embolism, when a blockage caused by a blood clot, air bubble or fat globule (embolism) forms in a blood vessel somewhere else in the body and is carried in the bloodstream to the brain or a blockage in the tiny blood vessels deep within the brain (lacunar stroke).
• The second type of stroke is a bleed, when a blood vessel bursts, causing bleeding (haemorrhage) into the brain. This is called a haemorrhagic stroke. It may be caused by an intracerebral haemorrhage, when a blood vessel bursts within the brain or a subarachnoid haemorrhage, when a blood vessel on the surface of the brain bleeds into the area between the brain and the skull (subarachnoid space).
• A transient ischaemic attack (TIA) often called a mini-stroke, happens when the brain’s blood supply is interrupted for a very brief time. The symptoms are very similar to a stroke (such as weakness on one side of the body, loss of sight and slurred speech) but they are temporary - lasting a few minutes or hours, and then disappearing completely within 24 hours. In a TIA, the affected part of the brain is without oxygen for just a few minutes. A TIA is a sign that part of the brain is not getting enough blood and that there is a risk of a more serious stroke in the future. So, you should not ignore signs of a TIA - get medical help as soon as you can.

Common symptoms

The first signs that someone has had a stroke are very sudden. Symptoms include numbness, weakness or paralysis on one side of the body (signs of this may be a drooping arm, leg or lower eyelid, or a dribbling mouth), slurred speech or difficulty finding words or understanding speech, sudden blurred vision or loss of sight, confusion or unsteadiness and a severe headache.

Use the Face-Arm-Speech Test (FAST)

Three simple checks can help you recognise whether someone has had a stroke or mini-stroke (transient ischaemic attack - TIA).
F Facial weakness: Can the person smile? Has their mouth or an eye drooped?
A Arm weakness: Can the person raise both arms?
S Speech problems: Can the person speak clearly and understand what you say?
T Test these symptoms.

If you see any of these signs, call 999 immediately.

Acute Stroke Unit

The Stroke Unit at Yeovil District Hospital is located on level 9 in Sparkford Ward. The purpose of the unit is to:

• Get a diagnosis
• Reduce the risk of complications
• Reduce the risk of a further stroke
• Maximise recovery

The time recovery takes varies from a few days to several months, the team will talk with you about your situation. Patients will probably need more tests in order to understand the diagnosis and reduce the risk of a further stroke.

These may include a brain scan (MRI or CT scan), heart scan (echocardiogram), neck scan (carotid duplex) or blood tests. The results take several days for some of these tests.It is possible that when the tests have been completed you may still need therapy input but no longer need to stay at Yeovil District Hospital. We will normally transfer patients to one of the community hospitals that have specialist stroke staff so the rehabilitation can continue.

Visiting

Visiting hours are 2.30 – 4.30pm and 6.30 – 8.30pm. Visiting outside of these hours should be discussed with the nurse in charge in advance. The telephone number is 01935 384363.

Often following a stroke the body recovers by sleeping and it is not uncommon for patients to only manage visitors for a short time before they fall asleep. Short frequent visits over a week are often more beneficial than a single long visit. It is our experience that in the first few days patients tend to prefer only immediate family to visit.

Visitors play a crucial and active role in aiding recovery. We have included a few tips and suggestions from past patients, relatives and staff to make the visits as worthwhile and enjoyable as possible:

• Conserve your visiting energy, you may be visiting for many weeks and it is important to look after yourself.
• Don’t worry if the patient you are visiting is emotional when you visit, this is quite common.
• Visiting can be very tiring and 20 minutes is often long enough. Small children visiting may find the hospital frightening and boring so prepare them.
• Surprise visits are much appreciated but check with staff before setting out.
• Do not feel you have to talk all of the time, a held hand or gentle touch can offer comfort (be sure to gel your hands first). A manicure or hand massage can also help.
• Check with staff if they want you to sit on a certain side of the bed. Often by sitting on the patient's “bad” or affected side helps them to remember to use it.
• Small gifts like fruit and sweets are welcome but do check with staff about the patient's ability to swallow.

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