Introduction

 
A stroke is defined as a sudden loss of brain function caused by a blockage or rupture of a blood vessel to the brain.  Blood does not reach certain parts of the brain, thus resulting in these parts being injured.
 
Stroke is Singapore’s 4^th most common cause of death and a major cause of disability.  The number of deaths and admissions to Singapore hospitals for stroke has been rising.  According to the Singapore National Stroke Association, each year approximately 10,400 are admitted to Singapore hospitals for stroke or TIA (Transient Ischemic Attack).

Stroke can be divided into two types:
 
A. Ischemic (blood vessel in the brain becomes clogged)
B. Hemorrhagic (blood vessel in the brain ruptures or leaks)

Ischemic stroke is caused by:
 
1. Blockage in a blood vessel, so that blood cannot flow to that part of the brain that the vessel supplies.  It can be a blood clot, fat or air bubble.  The blockage may form in an artery in the brain or a clot that has formed in a larger artery in the chest or neck.  It may break away and be carried by the bloodstream until it becomes lodged in a smaller artery in the brain.

2. Tumour in the brain compressing on the artery in the brain.

3. Blood clot forms in an artery in the brain already narrowed by cholesterol deposits.

 
Hemorrhagic stroke:
 
Most haemorrhagic strokes are spontaneous, meaning there are no underlying causes such as tumours or blood abnormalities. The blood vessel within the brain bursts, causing blood to leak inside the brain.  This bleeding can be caused by high blood pressure, head injury or weak artery wall from birth.

    

Return to Top

 

Risk Factors

 

Risk factors that cannot be modified:

 

-	Ageing: Generally as we grow older, the risk are higher but nowadays due to our high fat, high salt diet plus smoking, younger people are getting stroke much earlier.
-	Gender: males are more prone than females.
-	Family history

 

Several contributing factors to stroke that you can control:

 

 

Other conditions predispose to stroke include:

 

-	Atrial fibrillation (Quivering heart)
-	Atherosclerosis (Hardening of arteries)
-	Heart failure (Heart unable to pump well)

 

Return to Top

 

Warning Signs of Stroke

 

►	Sudden loss of vision in one or both eyes.
►	Numbness, weakness or paralysis of the face, arms or leg on one or both sides of the body.
►	Difficulty in speaking or slurred speech.
►	Sudden and severe headache.
►	Difficulty in swallowing.
►	Dizziness or unsteadiness of gait.

 

If you suspect that the person is having a stroke, call the ambulance 995 immediately.  Do not wait to see if symptoms go away.  Stroke is a medical emergency and every second counts.  When brain cells die, within 4 minutes when a stroke occurs, the damage is irreversible. 

 

Return to Top

 

Effects of Stroke

 

The effect of a stroke vary depending on its severity and on which part of the brain has been affected.

 

 

If blood supply to the affected area is cut off for a short while, the stroke is mild and temporary.  If blood supply to a large part of the brain is cut off for a long time, the effects will be more severe and likely to be permanent.  Death may result in some cases.  Swelling around the blood clot usually gets worse in the first 24 to 48 hours.  Blood clots can threaten life by exerting increasing pressure that the rest of the brain is also affected.
 
Other effects of stoke include:

 

 

Those who suffers from a severe stroke and cannot get out of bed may also suffer from:

 

 

Return to Top

 

Homecare Tips

 

►	People who have had one stroke are at high risk of having another one. Follow strictly the treatment recommendations by your healthcare professionals.
►	Recognise the factors that cause the stroke and treat them as advised. For example, if the person have high blood pressure or diabetes, following a recommended diet plan can keep the conditions well controlled.
►	Physical therapy and other retraining methods are important to improving the person disabilities.  Assist and encourage any exercises a therapist suggests.  You and the rehabilitation professionals must work hand in hand to achieve greater results.
►	If the person have difficulty talking, use flash cards or other means for communication.
►	Recovery from stroke is a gradual process.  Do not let the slow progress nor failures discourage you.  Set small and easily attainable goals to work to.
►	Allow the person to do as much as he could.  Think of alternative ways in which he can perform a task, if necessary recommend assistive devices to help the person gain maximum independence.  Click here to view some assistive devices.
►	The person recovering from a stroke may cry very easily, confused, forgetful, withdrawn or even uncooperative.  Be patient, supportive and understanding; but there are time you need to be firm in your approach.
►	Post-stroke depression is common and it can adversely affect the person's recovery and rehabilitation.  Consult your doctors if the person shows signs of depression.
►	Modify the home environment as required.  For examples, add in fixtures like grab bars in the toilets and around the bed to make the area safe Good lightings and a call bell in the toilet is important too.
►	Falls are common in people with stroke.  A safe home environment  will reduce the risk.

 

Return to Top