The Severities of Stroke

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Introduction: National Stroke Week

This week marks National Stroke Week, a pivotal time dedicated to raising awareness about stroke, its impact on Australians, and the critical actions required during a stroke event. Strokes are a major health issue in Australia, with significant consequences for the community, healthcare system, and individuals affected. In this issue, we will explore what stroke entails, the various types of stroke, their early signs, and what to do in the event of a stroke.

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Stroke in Australia: A Snapshot of the Current Scenario

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Stroke is one of Australia's biggest killers and a leading cause of disability. According to the Stroke Foundation, stroke affects more than 27,400 Australians each year—that’s one stroke every 19 minutes. It's estimated that around 445,087 Australians are living with the effects of stroke. This includes people of all ages, with over 80% of strokes occurring in people aged 65 years and older, although they can and do occur at any age. The financial cost to the community is immense, with direct costs to the healthcare system estimated at $5 billion annually.

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The severity of a stroke is immense, and is recognised as a medical emergency.

In 2017, through a joint venture between the Royal Melbourne Hospital (RMH), The University of Melbourne (UoM), and Ambulance Victoria, the Mobile Stroke Unit (MSU) was developed. The MSU is a specialist ambulance within the Ambulance Victoria fleet, that can be dispatched based on a patient’s symptoms described over the phone.

The MSU is a specifically equipped vehicle, with in-build imaging machines that can aid in detecting the type of stroke an individual may be having. In addition to two paramedics, the MSU is also staffed with a neurologist, a radiographer and a stroke nurse. This allows for assessment and treatment to begin immediately in the ambulance, rather than after arrival at the hospital.

Since its development in 2017, the MSU has treated close to 3000 patients, 55% of which have been diagnosed with some sort of stroke.

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What is a Stroke:

Stroke is defined as a when blood flow to the brain in interrupted. This can present as a blockage of blood flow to the brain, or to a section of the brain, or when there is sudden bleeding in the brain.?

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Stroke can be classified into three main types, each with distinct causes and implications for treatment and recovery:

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1.?????? Ischemic Stroke:

This is the most common type, accounting for about 85% of all cases. It occurs when a blood clot blocks or narrows an artery leading to the brain, causing reduced blood flow. Ischemic strokes can be caused by clots forming in the brain or traveling from elsewhere in the body to the brain.

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2.?????? Haemorrhagic Stroke:

Making up about 15% of stroke cases, this type happens when a blood vessel in the brain bursts, leading to bleeding (haemorrhage) in or around the brain. Haemorrhagic strokes can be caused by conditions such as high blood pressure, aneurysms, arteriovenous malformations, or head injury.

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3.?????? Transient Ischemic Attack (TIA):

Often called a “mini-stroke”, a TIA is a temporary period of symptoms similar to those of a stroke. A TIA does not cause permanent damage and is caused by a temporary decrease in blood supply to part of the brain. TIAs should be taken seriously as they often precede a ?stroke.

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Early Signs of Stroke

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Early signs of stroke can be the difference between recovery and significant disability or death. Common signs of stroke can be remembered with the acronym F.A.S.T.:

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• Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
• Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
• Speech Difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?
• Time to call emergency services: If someone shows any of these symptoms, even if the symptoms go away, call 000 immediately. Check the time so you'll know when the first symptoms appeared.

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What to Do If You Suspect a Stroke

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If you think you or someone around you is having a stroke, it’s critical to act immediately. Here are the steps you should take:

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1. Call Emergency Services: Dial 000 immediately. Provide clear information about the symptoms and the time they started.
2. Do Not Drive to the Hospital: Wait for an ambulance. Medical personnel will begin life-saving treatment on the way to the hospital.
3. Monitor the Person: While waiting for emergency services, monitor the person closely. If they are conscious, keep them comfortable and calm. If they are unconscious, ensure they are breathing and have a clear airway.
4. Prepare Information: If possible, gather information about any medications the person is taking and their medical history, as this will be important for hospital staff.

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The Importance of Awareness and Quick Action

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Stroke is a medical emergency that requires immediate action. National Stroke Week serves as an important reminder of the need for awareness, quick response, and education about the signs of stroke. By increasing community understanding and improving response times, we can significantly reduce the devastating impact of strokes across Australia. Remember, acting F.A.S.T. can save lives and improve recovery outcomes.

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Stay informed, stay prepared, and let’s work together to lessen the burden of stroke in our communities.

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?Written by: Gabrielle Street (BPT, APAM)

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References:

1.?????? Stroke Foundation – Australia, Facts and figures about stroke. (2023). https://strokefoundation.org.au/about-stroke/facts-and-figures-about-stroke?

2.?????? Australian Institute of Health and Welfare, Cardiovascular disease, diabetes and chronic kidney disease—Australian facts: Prevalence and incidence. (2021). https://www.aihw.gov.au/reports/heart-stroke-vascular-disease/cardiovascular-health?

3.?????? Ambulance Victoria, Time saved is a brain saved: Five years on the road for Australia’s only Mobile Stroke Unit. (2022). https://www.ambulance.vic.gov.au/time-saved-is-a-brain-saved/

4.?????? Healthline. Everything you need to know about stroke. (2024). https://www.healthline.com/health/stroke#causes-and-types

5.?????? Royal Australian College of General Practitioners, Guidelines for the management of absolute cardiovascular disease risk. (2019) https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/guidelines-for-preventive-activities-in-general-practice/8-prevention-of-vascular-and-metabolic-disease/absolute-cardiovascular-disease-risk?

6.?????? Everyday Health, Stroke Symptoms and Causes. (2022). https://www.everydayhealth.com/stroke/guide/symptoms/

7.?????? Australian Government Department of Health. Australia’s long term national health plan to tackle stroke. (2022). https://www.health.gov.au/health-topics/stroke

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