Stroke

A stroke occurs when blood flow is interrupted in a part of the brain and brain cells that no longer receive blood are damaged or die, resulting in the sudden loss of brain function.

The consequences of stroke vary depending on the area of the brain that has been damaged and the extent of the damage. It is a medical emergency.

There are three types of stroke:

• Ischemic stroke (most common type), caused when an artery in the brain is blocked by a blood clot (a mass of blood that makes it thicker) or by a build up of cholesterol deposits on the artery walls
• Hemorrhagic stroke, caused when an artery in the brain ruptures, resulting in bleeding in or around the brain
• Transient ischemic attack (TIA), which occurs when a small clot blocks an artery briefly, impairing brain function temporarily, usually for less than one hour

There are signs that make it possible to recognize a stroke quickly. They are called the F‑A-S‑T signs of stroke:

• F - Face drooping
• A - Arm weakness
• S - Speech difficulty
• T - Time extreme medical emergency, you must call 911

In particular, a stroke includes the following signs and symptoms:

• Sudden weakness affecting one side of the body (arm, leg or face)
• Sensation of numbness or tingling in the face, arm or leg
• Difficulty speaking or understanding what other people are saying (sudden confusion)
• Visual disturbances, such as double vision or loss of vision, especially in one eye
• Dizziness or loss of balance, especially if these symptoms are accompanied by other signs of stroke
• Sudden, severe and unusual headache

Rapid intervention is critical when a stroke occurs. It reduces the sequelae significantly and increases the person’s chances of functional recovery and maintenance of their quality of life. People who are at risk of or who have had a stroke can access care and services that will reduce the risk of having a stroke and the resulting sequelae.

For example, for an ischemic stroke, the proposed emergency treatments are as follows:

• Thrombolysis: a medication dissolves the clot
• Mechanical thrombectomy: the clot is removed using a removal device introduced into the artery during surgery

The treatments are effective and safe. They reduce the sequelae associated with stroke and mortality while improving people’s quality of life.

Appropriate rehabilitation significantly improves recovery and quality of life for people who have had a stroke. Resuming day‑to‑day activities and participating in community life will help a person who has had a stroke recover their maximum capacities. Their loved ones will be able to support them to avoid isolation and help them regain as much autonomy as possible, taking their living environment into account.

Regular follow‑up will help maintain their capacities and prevent recurrences.

Stroke is a medical emergency. If you or a family member or friend experiences one or more signs of stroke, call 911 immediately. The 911 responder will send an ambulance and stay in contact with you. Do not drive your vehicle to the hospital. Paramedics have all the equipment to transport the person in need of care quickly and safely to the nearest and most appropriate hospital.

The repercussions of stroke vary from person to person depending on various factors. The consequences of a stroke may be, for example:

• Difficulty communicating
• Paralysis or weakness on one side of the body
• Impaired sensation in the half of the body affected
• Difficulty swallowing
• Incontinence
• Changes in behaviour
• Changes in mood
• Depressive disorders
• Impaired memory
• Learning or problem‑solving difficulties
• Difficulty making decisions
• Difficulty concentrating on a task
• Fatigue
• Impaired vision
• Pain
• Involuntary muscle spasms

Knowing the signs of stroke (F‑A-S‑T signs) makes it possible to act quickly in the event of a stroke and to limit the severity of the sequelae.

Alternatively, to prevent the risk of stroke, you can:

• treat health conditions that are a risk factor for stroke, such as high blood pressure, atrial fibrillation, diabetes, high cholesterol, sleep apnea, vascular cognitive impairment
• adopt healthy lifestyle habits such as a healthy diet, adopt an active lifestyle, have a healthy weight, stop smoking, vaping or using recreational drugs, reduce alcohol consumption and manage your stress

There is no screening for stroke. However, it is possible to reduce the risk of stroke by following prevention advice.

The risk of stroke increases with age.

Other factors can also increase the risk of stroke:

• Certain times of a woman’s life (e.g., pregnancy, menopause or old age) or when taking oral contraceptives or hormone replacement therapy
• Having a close relative who has had a stroke or TIA
• Being of Indigenous, African or South Asian descent
• Having had a TIA, stroke or heart disease
• Eating too much fat, physical inactivity
• Smoking
• Alcohol consumption
• Being overweight
• Having health problems such as high blood pressure, atrial fibrillation, diabetes, high cholesterol, sleep apnea or vascular cognitive impairment