Strokes have been making the headlines of late - Donald Glover revealed he suffered a stroke last year, Hailey Bieber suffered a mini stroke in 2022 and Jamie Foxx had life-threatening cerebral haemorrhage in 2023 which led to him being hospitalised and in rehabilitation for over a year.
There's a good reason this health issue sparks worry. Known commonly as stroke, cerebral haemorrhage or haemorrhagic stroke, it's one of the leading causes of disability and death worldwide.
Depending on where and when it happens, and how quickly a person receives treatment, it can be so severe that it results in death.
To better understand this medical condition, and more importantly, to know if we can prevent it, we spoke to renowned neurologist Dr Gurutz Linazasoro. He explains the causes, warning signs, treatments, after-effects and what we can all do to minimise the risk.
What causes a stroke and how does it affect the brain?
A stroke occurs when an artery or blood vessel in the brain ruptures, causing blood to pool in the brain tissue. As Dr Linazasoro points out, "High blood pressure is the most common cause, although other factors such as arteriovenous malformations, head injuries, ageing and clotting disorders can also play a role."
As we get older, arteries become more fragile, which increases the risk of this type of haemorrhage. Furthermore, situations like the use of anticoagulant medication can make a person more susceptible to having a stroke, making regular medical monitoring essential for those with risk factors.
Haemorrhagic vs. ischaemic stroke: What's the difference?
Dr Linazasoro clarifies that the terms are indeed related. A cerebral haemorrhage is the same thing as a haemorrhagic stroke, one of the two major categories of stroke.
"The overall term 'stroke' covers both cerebral infarctions (caused by a blocked artery) and cerebral haemorrhages (which result from a burst artery). When referring to the latter, we mean an intracerebral haemorrhage that occurs within the brain tissue."
However, not all strokes are haemorrhagic. Most are ischaemic, which means they are caused by a lack of blood supply to an area of the brain. Both types share common risk factors, such as high blood pressure and smoking, but they necessitate distinct treatments. This difference underscores just how crucial an accurate and timely diagnosis is.
Recognising red flags: 5 key stroke warning symptoms
One of the most crucial things to be aware of is how to recognise the symptoms of a stroke. The most common include:
- A sudden and intense headache, completely different from any headache experienced before.
- The abrupt loss of the ability to speak or understand language.
- Weakness or paralysis on one side of the body.
- Difficulty walking, loss of balance or coordination.
- Numbness or a tingling sensation (pins and needles) in any part of the body.
Life after a stroke: Common after-effects and long-term recovery
The long-term effects of a stroke depend on several factors, such as the severity of the brain damage, how quickly treatment is received, and the affected area of the brain.
Among the most common after-effects are:
- Weakness or paralysis: This can affect the whole body, one side of the body, or a specific limb, making daily activities difficult.
- Speech and language problems: Some people may struggle to speak, understand, read, or write, a condition known as aphasia.
- Cognitive changes: These can include problems with memory, attention, planning and problem-solving.
- Loss of sensation: Tingling or numbness in certain areas of the body.
- Visual problems: Partial or total loss of sight in one or both eyes, or difficulty focusing.
- Emotional instability: Mood swings, depression and anxiety are common due to the emotional impact of the illness.
- Chronic pain: Some people develop neuropathic pain as a result of the brain damage.
The doctor emphasises that the recovery process after a stroke "can be quite lengthy and requires a multidisciplinary approach, involving physiotherapists, speech and language therapists (often referred to as logopedists), and psychologists."
Medication may also be required and rehabilitation plays a vital role in improving patients' quality of life and helping them regain any lost abilities.
Crucially, in the case of a haemorrhagic stroke, just as with an ischaemic stroke, a correct diagnosis and swift action are absolutely essential to limit any long-term after-effects.
Treatment options: How doctors stop and reverse stroke damage
Stroke treatment depends on multiple factors, such as the location of the bleeding, its severity, and the underlying cause. In general, as the neurology specialist explains, the options will may include:
- Neurosurgery: In the most severe cases, this is performed to drain the haematoma (blood clot) and reduce pressure inside the skull (intracranial pressure).
- Embolisation: This is a procedure aimed at stopping the bleeding, especially in cases involving arteriovenous malformations or aneurysms.
- Draining: Used to relieve intracranial pressure and treat complications like hydrocephalus (water on the brain).
- Risk factor management: It is crucial to manage high blood pressure, cholesterol and other factors that predispose a person to these events.
- Supportive therapies: These include physical and cognitive rehabilitation to recover affected functions, such as speech or mobility.
"A healthy lifestyle, controlling your blood pressure, avoiding smoking, and having regular medical check-ups are the keys to minimising the risk"
"It's vital to get an early diagnosis via a CT scan (or CT head scan) or MRI (Magnetic Resonance Imaging) - and sometimes a cerebral angiogram with MRI - so doctors know exactly what they are dealing with and how best to treat the patient," advises the neurologist.
Essential stroke prevention: Reducing your risk
For Dr Linazasoro, prevention is the best strategy to reduce the incidence of strokes. "A healthy lifestyle, controlling your blood pressure, avoiding smoking, and having regular medical check-ups are the keys to minimising the risk."
About the expert:
Dr Gurutz Linazasoro is a neurologist at Policlínica Gipuzkoa Hospital in San Sebastian, Spain and is the Executive President of Vive Biotech.