WHAT IS STROKE?
A stroke is a potentially life-threatening condition that is caused by a disruption of blood flow to the brain. If the supply of blood is interrupted, brain cells begin to die. In turn, this can result in brain injury, disability and possibly death.
When brain cells die, abilities controlled by that area of the brain can be lost. These abilities may include:
The way a stroke affects you depends on where the stroke occurs in the brain and how much of the brain is damaged.1
Of all the neurological disorders, stroke is one of the main causes of adult disability.1 Stroke can result in severe spasticity, which is where certain muscles are contracted continuously. This makes them tight and stiff, and can interfere with normal movement and posture.
If you or a member of your family has been affected by stroke, you are not alone. Around 1.1 million people suffer a stroke in Europe each year2 and there are millions more worldwide. Up to 13% of people who experience a stroke develop severe disabling spasticity.4-5
Fortunately, there are treatments which can reduce the impact of spasticity for some individuals.
WHAT CAUSES STROKE?
Strokes are caused by an interruption of blood flow to the brain. There are two main types of stroke: ischaemic and haemorrhagic.1
- An ischaemic stroke is caused by a blood clot in the blood supply to the brain. This type of stroke accounts for 87% of all cases.
- A haemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain.
There is a related condition which is known as a transient ischaemic attack (TIA) – sometimes referred to as a “mini-stroke”. This is caused by a temporary interruption of blood supply to the brain.
TIAs cause the same symptoms of a stroke but the effects are usually only temporary, usually last less than five minutes.1,3 If you think you are experiencing or have experienced a TIA, get medical help urgently. TIAs are often a warning sign that you may have a full stroke in the near future.1,3
WHAT ARE THE RISK FACTORS FOR STROKE?
A stroke can happen to anyone. However, you can control or treat many common risk factors for stroke, including1:
- High blood pressure
- Cigarette smoking
- Heart disease
- Circulation problems (e.g. atherosclerosis)
- High cholesterol
Some of the risk factors for stroke you can’t control include1:
- Age: stroke risk increases after the age of 55
- Gender: women experience more strokes than men, mainly because they live longer
- Race and ethnicity: Asian Pacific islanders, African Americans or Hispanic people have higher risk of stroke than Caucasians
- Family history of stroke
WHAT ARE THE SYMPTOMS OF STROKE?
The symptoms of stroke come on suddenly, and may include:1
- Numbness or weakness of the face, arm or leg (especially on one side of the body)
- Confusion, trouble speaking or understanding speech
- Trouble seeing in one or both eyes
- Trouble walking, dizziness, loss of balance or coordination
- Severe headache with no known cause
A stroke is always a medical emergency. If you suspect a stroke, you should call for emergency medical help immediately, even if the symptoms begin to lessen while you are waiting for help to arrive. Ambulance paramedics are trained to recognise and treat stroke and will transport people with suspected stroke to the most appropriate emergency facilities.
HOW IS STROKE DIAGNOSED?
There are a number of tools that can be used for stroke diagnosis and to determine stroke risk.3 These include a full physical examination and blood tests to determine blood sugar and cholesterol levels.
There are also a number of specialised tests for diagnosing stroke or screening for stroke risk. These may include:
- A computed tomographic (CT) scan works like an X-ray but it combines multiple images to build a 3-D picture of the brain which can be used to identify whether and where in the brain a stroke has occurred
- A magnetic resonance imaging (MRI) scan uses both magnetism and radio waves to build a more detailed picture of the inside of your body. Because of this greater level of detail, an MRI scan can be used to identify strokes which are smaller or less common parts of the brain. MRI scans are also used to identify people who have had a transient ischaemic attack (TIA)
- A cardioid ultrasound scan uses high-frequency soundwaves to determine whether there are blockages or narrowing of the arteries in the neck which lead to the brain.
- A cerebral angiogram uses a thin, flexible tube (catheter) inserted usually at the level of your groin and X-rays to create an image which can be used to check for abnormalities or blockages in the blood vessels in the head and neck
- An echochardiogram uses ultrasound to create an image of your heart which can be checked for any problems
SPASTICITY AND STROKE
If you’ve suffered a stroke, you may begin to experience spasticity. Spasticity after stroke is caused by damage or injury to the part of the central nervous system (the brain or spinal cord) that controls voluntary movement.
In a stroke, some brain cells in certain areas die as a result of an interruption of the blood supply to this area. This damage disrupts important signals between the nervous system and muscles, creating an imbalance that increases muscle activity or spasms – known as spasticity. The changes in the brain may interrupt the flow of messages between the brain and the muscles, leading to mild or severe spasticity – characterised by stiffness and spasm of the muscles. This can cause a tight fist, bent elbow, arm pressed against the chest, stiff knee and pointed foot.1
Stroke spasticity can make movement, posture and balance difficult. It may affect your ability to move one or more of your limbs, or to move one side of your body. Sometimes spasticity is so severe that it gets in the way of daily activities, sleep patterns and care giving.
Up to 40% of stroke survivors have some degree of spasticity (muscle tightness and stiffness), ranging from mild to severe.4 There are a range of treatment options for spasticity after stroke. These can reduce the impact of spasticity and improve quality of life for some individuals.
One of the possible symptoms of stroke is spasticity, which is a movement disorder where muscles become tight, stiff and difficult to control.
Evidence suggests that spasticity after stroke has a negative impact on quality of life for people with this condition and their caregivers.
1.1 million people suffer a stroke in Europe each year.2
- Up to 40% of stroke survivors have some degree of spasticity4,5,7,8-10
- Up to 13% live with a more severe degree of spasticity4,5
post stroke spasticity
impact on patient
*vs. stroke patients without spasticity
National Stroke Association. What is Stroke. Available at: www.stroke.org. Accessed.March 2020
Truelsen T, Piechowski-Jo´z´wiakb,C, Bonitaa R et al. Stroke incidence and prevalence in Europe: a review of available data. European Journal of Neurology 2006, 13: 581-598.
Mayo Clinic. Stroke. Available at: www.mayoclinic.org. Accessed March 2020
Dvorak EM, Ketchum NC, McGuire JR. The underutilization of intrathecal baclofen in poststroke spasticity. Top Stroke Rehabil.2011;18(3):195–202.
Watkins CL, Leathley MJ, Gregson JM, Moore AP, Smith TL, Sharma AK. Prevalence of spasticity post stroke. Clin. Rehabil. 2002;16(5):515-522.
Gillard PJ, Sucharew H, Kleindorfer D, et al. The negative impact of spasticity on the health-related quality of life of stroke survivors: a longitudinal cohort study. Health Qual Life Outcomes. 2015;13:159.
Welmer et al. Spasticity and Its association with functioning and health-related quality of life 18 months after stroke. Cerebrovasc Dis 2006;21:247–53.
Sommerfeld DK, Gripenstedt U, Welmer AK. Spasticity after stroke: an overview of prevalence, test instruments, and treatments. Am. J. Phys. Med. Rehabil. 2012;91(9):814-820.
Lundstrom E, Terent A, Borg J. Prevalence of disabling spasticity 1 year after first-ever stroke. Eur. J. Neurol. 2008;15(6):533-539.
Urban PP, Wolf T, Uebele M, et al. Occurence and clinical predictors of spasticity after ischemic stroke. Stroke. 2010;41(9):2016-2020.