The impact of a stroke on a person’s mobility, strength and dexterity can vary dramatically – unfortunately however, a stroke leaves many struggling to dress independently.

Designed to Care is dedicated to providing you with stroke clothing options to maintain your independence, dignity and assist with everyday care. Our open back and side zip clothing are particularly helpful in the case of stroke – choose the side that is easiest to ‘dress from’ and our clothes will work with you. Also, by replacing all buttons with pop-fasteners, you will find dressing quicker and easier.

A stroke is considered to be a chronic condition by HMRC, click here to find out more about chronic illness and disabled vat relief on adaptive stroke clothing

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Stroke

If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.


If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.

Even if the symptoms of a stroke disappear while you are waiting for the ambulance to arrive, you or the person having the stroke should still go to hospital for an assessment. Symptoms that disappear may mean you have had a transient ischaemic attack (TIA) and you could be at risk of having a full stroke at a later stage.

After an initial assessment, you may need to be admitted to hospital to receive a more in-depth assessment and, if necessary, for specialist treatment to begin.

Recognising the signs and symptoms of a stroke

The signs and symptoms of a stroke vary from person to person but usually begin suddenly. As different parts of your brain control different parts of your body, your symptoms will depend upon the part of your brain affected and the extent of the damage.

The main stroke symptoms can be remembered with the word FAST: Face-Arms-Speech-Time.

  • Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped
  • Arms – the person with suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
  • Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
  • Time – it is time to dial 999 immediately if you see any of these signs or symptoms

It is important for everyone to be aware of these signs and symptoms. If you live with or care for somebody in a high-risk group, such as someone who is elderly or has diabetes or high blood pressure, being aware of the symptoms is even more important.

Symptoms in the FAST test identify about nine out of 10 strokes.

Other signs and symptoms may include:

  • numbness or weakness resulting in complete paralysis of one side of the body
  • sudden loss of vision 
  • dizziness 
  • communication problems, difficulty talking and understanding what others are saying 
  • problems with balance and coordination 
  • difficulty swallowing 
  • sudden and severe headache, unlike any the person has had before, especially if associated with neck stiffness
  • blacking out (in severe cases)

'Mini-stroke' or transient ischaemic attack (TIA)

The symptoms of a transient ischaemic attack (TIA) are the same as a stroke, last from between a few minutes to a few hours, then completely disappear. However, never ignore a TIA as it is a serious warning sign there is a problem with the blood supply to your brain.

There is about a one in 10 chance those who have a TIA will experience a full stroke during the four weeks following the TIA. If you have had a TIA, you should contact your GP, local hospital or out-of-hours service, as soon as possible.

Read more about types of stroke at The Stroke Association.

Stroke

Strokes are usually diagnosed by studying images of the brain (brain imaging) and carrying out physical tests.


Strokes are usually diagnosed by studying images of the brain (brain imaging) and carrying out physical tests.

Your doctor may check for the causes of your stroke by taking blood tests to determine your cholesterol and blood sugar levels, checking your pulse for an irregular heartbeat and taking a blood pressure measurement.

Even if the physical symptoms of a stroke are obvious, brain imaging should also be carried out to determine:

  • if the stroke has been caused by a blocked artery or burst blood vessel
  • which part of the brain has been affected
  • how severe the stroke is
  • the risk of a transient ischaemic attack (TIA)

Different treatment is required for each type of stroke so a rapid diagnosis will make treatment more straightforward.

CT and MRI scans

Two common methods used for brain imaging are a computer tomography (CT) scan and a magnetic resonance imaging (MRI) scan.

A CT scan is like an X-ray, but uses multiple images to build up a more detailed, three-dimensional (3D) picture of your brain. An MRI scan uses a strong magnetic field and radio waves to produce a detailed picture of the inside of your body.

The type of scan you may have in hospital depends on your symptoms. If it is suspected you had a major stroke, a CT scan is sufficient to identify whether the stroke is due to bleeding or clotting. It's quicker than an MRI scan and improves the chances of rapidly delivering treatments such as clot-busting drugs (thrombolysis) that might be used in appropriate cases, but are time-limited and require the results of the scan before the treatment can be given safely.

For people with more complex symptoms, where the extent or location of the damage is unknown, and in patients who have recovered from a transient ischaemic attack, an MRI scan is more appropriate. This will provide greater detail of brain tissue, allowing smaller, or more unusually located strokes to be identified.

All patients with suspected stroke should receive a brain scan within 24 hours. Some patients should be scanned within the hour, especially those who:

  • might benefit from clot-busting drugs (thrombolysis) such as alteplase or early anticoagulant treatment
  • are already on anticoagulant treatments
  • have a lower level of consciousness

After the injection of a dye into an arm vein, both CT and MRI can be used to take pictures of the blood vessels in the brain, as well as the blood vessels in the neck that take blood to the brain from the heart. This is known as CT or MR angiography and is often done immediately after taking pictures of the brain itself.

Read more information at The Royal College of Radiologists.

Swallow tests

A swallow test is essential for anybody who has had a stroke.

Swallowing problems affect over a third of people after a stroke. When a person cannot swallow properly, there is a risk that food and drink may get into the windpipe and then into the lungs (called aspiration), which can lead to chest infections and pneumonia.

The test is simple. The person is given a few teaspoons of water to drink. If they can swallow this without choking and coughing they will be asked to swallow half a glass of water.

If they have any difficulty swallowing, they will be referred to the speech and language therapist for a more detailed assessment. They will usually be kept ‘nil by mouth’ until they have seen the therapist and may therefore need to have fluids or food given directly into an arm vein (intravenous drip) or through the nose using a nasogastric tube.

Heart and blood vessel tests 

Further tests on the heart and blood vessels might be carried out later to confirm what caused the stroke. These may include:

Ultrasound (carotid ultrasonography)

An ultrasound scan uses high frequency sound waves to produce an image of the inside of your body. Your doctor may use a wand-like probe (transducer) to send high-frequency sound waves into your neck. These pass through the tissue creating images on a screen that will show if there is any narrowing or clotting in the arteries leading to your brain.

This type of ultrasound scan is sometimes known as a doppler scan or a duplex scan. Where carotid ultrasonography is needed, it should happen within 48 hours.

Catheter angiography (arteriography)

Dye is injected into your carotid or vertebral artery via a tube called a catheter. This gives a more detailed view of your arteries than can be obtained using ultrasound, CT angiography or MR angiography.

Echocardiogram

In some cases an echocardiogram may be used to produce images of your heart using an ultrasound probe placed on your chest (transthoracic echocardiogram). In addition, transoesophageal echocardiography (TOE) may also be used. This involves an ultrasonic probe which is passed down the foodpipe (oesophagus), usually under sedation. Because it's directly behind the heart, it produces a clear image of blood clots and other abnormalities that may not get picked up by the transthoracic echocardiogram.

Read more about hospital tests at The Stroke Association.

Stroke

Effective treatment of stroke has been found to prevent long-term disability and save lives.


Ischaemic strokes

Ischaemic strokes can be treated using a 'clot-busting' medicine called alteplase, which dissolves blood clots (thrombolysis). However, alteplase is only effective if started during the first four and a half hours after the onset of the stroke. After that time, the medicine has not been shown to have beneficial effects. Even within this narrow time frame, the quicker alteplase can be started the better the chance of recovery. However, not all patients are suitable for thrombolysis treatment.

You will also be given a regular dose of aspirin (an anti-platelet medication), as this makes the cells in your blood, known as platelets, less sticky, reducing the chances of further blood clots occurring. If you are allergic to aspirin, other anti-platelet medicines are available.

Anticoagulants

You may also be given an additional medication called an anticoagulant. Like aspirin, anticoagulants prevent blood clots by changing the chemical composition of the blood in a way that prevents clots from occurring. Heparin, warfarin and more recently rivaroxaban are examples of anticoagulants.

Anticoagulants are often prescribed for people who have an irregular heartbeat that can cause blood clots.

Blood pressure

If your blood pressure is too high, you may be given medicines to lower it. Medicines that are commonly used include:

  • thiazide diuretics
  • angiotensin converting enzyme (ACE) inhibitors
  • calcium channel blockers
  • beta-blockers
  • alpha-blockers

Read more about treating high blood pressure.

Statins

If the level of cholesterol in your blood is too high, you will be given a medicine known as a statin. Statins reduce the level of cholesterol in your blood by blocking an enzyme (chemical) in the liver that produces cholesterol.

Carotid stenosis

Some ischaemic strokes are caused by a narrowing in the carotid artery, which is an artery in the neck, which takes blood to the brain. The narrowing, known as carotid stenosis, is caused by a build-up of fatty plaques.

If the carotid stenosis is particularly bad, surgery may be used to unblock the artery. This is done using a surgical technique called a carotid endarterectomy. It involves the surgeon making an incision in your neck in order to open up the carotid artery and remove the fatty deposits.

Haemorrhagic strokes

Emergency surgery is often needed to treat haemorrhagic strokes to remove any blood from the brain and repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy.

During a craniotomy, a small section of the skull is cut away to allow the surgeon access to the cause of the bleeding. The surgeon will repair any damaged blood vessels and ensure there are no blood clots present that may restrict the blood flow to the brain. After the bleeding has been stopped, the piece of bone removed from the skull is replaced.

Following a craniotomy, the patient may have to be placed on a ventilator. A ventilator is a machine that assists someone with their breathing. It gives the body time to recover by taking over its normal responsibilities, such as breathing, and it will help control any swelling in the brain.

The patient will also be given medicines, such as ACE inhibitors, to lower blood pressure and prevent further strokes from occurring.

Transient ischaemic attack (TIA)

The treatment for a TIA involves addressing the risk factors that may have led to it, to try to prevent a bigger, more serious stroke.

If you have a TIA, the treatment you receive will depend on what caused it, but you will typically be given one of the medicines outlined above or a combination of them. So, if high blood pressure and high cholesterol levels put you at risk of having a stroke, you may be given a combination of statins and ACE inhibitors.

If the risk of a stroke is high due to a build-up of fatty plaques in your carotid artery, a carotid endarterectomy may be required.

Stroke

The best way to prevent a stroke is to eat a healthy diet, exercise regularly, and avoid smoking and excessive consumption of alcohol.


The best way to prevent a stroke is to eat a healthy diet, exercise regularly and avoid smoking and excessive consumption of alcohol.

Diet

A poor diet is a major risk factor for a stroke. High-fat foods can lead to the build-up of fatty plaques in your arteries and being overweight can lead to high blood pressure.

A low-fat, high-fibre diet is recommended, including plenty of fresh fruit and vegetables (five portions a day) and whole grains. You should limit the amount of salt you eat to no more than 6g (0.2oz) a day because too much salt will increase your blood pressure. Six grams of salt is about one teaspoonful.

There are two types of fat  saturated and unsaturated. You should avoid food containing saturated fats because these will increase your cholesterol levels.

Foods high in saturated fat include:

  • meat pies 
  • sausages and fatty cuts of meat 
  • butter 
  • ghee  a type of butter often used in Indian cooking 
  • lard 
  • cream 
  • hard cheese 
  • cakes and biscuits 
  • foods that contain coconut or palm oil.

However, a balanced diet should include a small amount of unsaturated fat, which will help reduce your cholesterol levels.

Foods high in unsaturated fat include:

  • oily fish 
  • avocados 
  • nuts and seeds 
  • sunflower, rapeseed, olive and vegetable oils

Read more about healthy eating and losing weight.

Exercise

Combining a healthy diet with regular exercise is the best way to maintain a healthy weight. Having a healthy weight reduces your chances of developing high blood pressure.

Regular exercise will make your heart and blood circulatory system more efficient. It will also lower your cholesterol level and keep your blood pressure at a healthy level.

The recommended level of cholesterol is 5mmol/litre (5 millimoles per litre of blood).

Blood pressure is measured using two figures. One figure represents the pressure of the heart as it contracts to pump blood around the body. This is known as the systolic pressure. The second figure represents the pressure of the heart as it rests, expands and fills with blood, while waiting for the next contraction. This is known as the diastolic pressure.

For most people, an ideal blood pressure is a systolic pressure of 90-120 millimeters of mercury (mmHg) and a diastolic pressure of 60-80mmHg. Or, as blood pressure is normally expressed, a level between 90/60mmHg or 120/80mmHg.

For most people, at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week is recommended.

If you are recovering from a stroke, you should discuss possible exercise plans with the members of your rehabilitation team. Regular exercise may be impossible in the first weeks or months following a stroke but you should be able to begin exercising once your rehabilitation has progressed.

Read more about health and fitness.

Smoking

Smoking doubles your risk of having a stroke. This is because it narrows your arteries and makes your blood more likely to clot.

If you stop smoking, you can reduce your risk of having a stroke by up to half. Not smoking will also improve your general health and reduce your risk of developing other serious conditions, such as lung cancer and heart disease.

The NHS Smoking Helpline can offer advice and encouragement to help you quit smoking. You can call on 0300 123 1044, or visit NHS Smokefree.

Read more about stopping smoking.

Alcohol

Excessive alcohol consumption can lead to high blood pressure and an irregular heartbeat (atrial fibrillation). Both are major risk factors for stroke.

Because alcoholic drinks are rich in energy (high in calories) they also cause weight gain. Heavy drinking multiplies the risk of stroke by more than three times.

Read more about alcohol.