Stroke and TIA: a guide to healthcare

Stroke is a leading cause of death and disability.

High quality care can save lives, reduce disability and improve outcomes

The guide is not a substitute for personal  medical advice – always seek professional help. Remember, healthcare professionals will not share information about a patient unless they have been given permission to do so.

Stroke is a medical emergency – dial 999

Expert care in the immediate hours following a stroke can save lives and reduce disability. If you think someone might be having a stroke then do not delay – dial 999 immediately. If you are not sure then do the FAST test as explained in this video.

 What is a stroke?

Stroke is often described as a brain attack which occurs when part of the blood supply to the brain is cut off.  This can be due to a blockage in one of the blood vessels (ischaemic stroke or infarction), or a bleed in the brain (haemorrhage).  Most stroke patients (85%) have a blockage.  Although haemorrhagic strokes are less common (around 15%), they are generally more severe and more likely to be fatal.

The majority (59%) of strokes occur in older people, but during the last decade there has been a drop in the average age for first-time strokes.

Stroke affects people differently, depending on the size of the stroke, the part of the brain that was affected and the underlying health of the person.  The most common effects of a stroke can include:

• • Loss of strength, movement and/or balance

• • Loss of speech and vision

• • Emotional changes

• • Changes in memory, concentration and other thought processes

• • Changes in body sensations such as touch, temperature or pain

• • Loss of energy and fatigue

• • Urinary or faecal incontinence

• • Difficulty swallowing and eating

• • Depression – A third of stroke survivors experience post- stroke depression.

Stroke is a type of cardiovascular disease (CVD). CVD is an umbrella term for heart and circulatory diseases, including coronary heart disease, angina, heart attack, congenital heart disease, hypertension and vascular dementia. CVD is frequently linked with Diabetes and Chronic Kidney Disease (CKD) and is a common contributor to Frailty and Multimorbidity.

What’s the difference between a Stroke and a TIA?

TIA stands for Transient Ischaemic Attack. It is a short lived or temporary neurological disturbance caused by lack of blood supply to the brain, retina or spinal cord. A TIA has a sudden onset and can last from a few minutes to 24 hours. Most people have complete resolution of symptoms and signs within 1 hour.

This video provides a brief and simple clarification of the differences between stroke and TIA.

Care services

Health and care services for stroke patients have improved dramatically over the last 15 years and as a result deaths from stroke have declined by 49% and levels of disability have fallen too.  A significant part of stroke care occurs in hospital (ideally in specialised stroke units) with additional rehabilitation services provided in the community following discharge.

Many people who have a stroke need long‑term support to help them manage any difficulties they have, participate in society and regain their independence. Stroke rehabilitation aims to help people to restore or improve their physical and mental functioning, adapt to any loss of function and work towards regaining a meaningful role for the individual. It involves many different specialists for different areas of care depending on the person’s needs.

The number of stroke survivors who receive the recommended amount of rehabilitation, including speech and language therapy and vocational therapy, tends to lag behind other improvements in stroke care.

This video also gives a helpful overview of how stroke care is developing in the NHS.  The video was launched in 2017 but there have already been many improvements including the creation of more expert stroke centres.

Ongoing care in the community

Unfortunately, around two thirds of stroke survivors leave hospital with a disability which can make it difficult for them to live as they did before and at least one fifth are dependant on family and friends.

In surveys, unpaid carers say that the emotional impact of stroke is the hardest thing to cope with and around 80% experience anxiety.

The Stroke Association is the leading UK charity which supports stroke survivors and their carers