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Are stroke symptoms permanent?

What are stroke symptoms?

Symptoms for a stroke tend to come on suddenly and it’s vital that you call 999 if you suspect that someone is having a stroke. A high-profile NHS campaign highlighted the symptoms as an easy to remember acronym, FAST:

  • Face – the face may have dropped on one side, drooped or the person may not be able to smile
  • Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness
  • Speech – their speech may be slurred or garbled, or the person may not be able to talk despite appearing to be awake; they may also have problems understanding what you’re saying
  • Time – it’s time to dial 999 immediately if you notice any of these signs or symptoms.

Although the FAST test identifies most strokes, there may occasionally be different symptoms. These include complete paralysis of one side of the body, sudden loss or blurring of vision, dizziness, confusion, problems with balance and co-ordination, difficulty swallowing (dysphagia), a sudden and very severe headache, loss of consciousness. There may be other reasons for these symptoms though and they should always be checked by medical professionals.

Stroke symptoms that come on suddenly but then disappear within 24 hours mean it was most likely a transient ischaemic attack (TIA), also known as a mini-stroke, but this could be a pre-cursor of a more serious stroke and will give the medical team the opportunity to begin treatment to try and prevent that happening.

Brain power

There are two main types of strokes, ischaemic and haemorrhagic. Ischaemic strokes are the most common and are caused by a blood clot blocking the flow of blood and oxygen to the brain. This is because the arteries have narrowed which can happen with age, but also happens due to risk factors such as smoking, high blood pressure (hypertension), obesity, high cholesterol levels, diabetes, and excessive alcohol intake.

Haemorrhagic strokes are less common and are caused when a blood vessel inside the skull bursts and bleeds into and around the brain. This is caused primarily by high blood pressure which can be brought on by being overweight, drinking excessive amounts of alcohol, smoking, lack of exercise, or stress.

The human brain is incredible, it controls every aspect of our functioning, much like the CPU of a computer, however this also makes it vulnerable to lack of oxygen and blood flow that can happen with a stroke. This is why time is so crucial when someone is suspected of having had a stroke, because the longer it is before medical intervention happens, the more of the brain can die off due to not receiving the vital nutrients and oxygen that are carried in the blood flow. For instance, if the part of the brain that controls movement on the right-hand side of the body is affected, it means the person will lose their mobility on that side.

If the blockage can be relieved in time though, that person may have only temporary paralysis that can be improved through physiotherapy or other treatment. The same can be the case for speech, swallowing reflex, motor skills and any other aspects of our cognitive function.

Early recovery

Realistically, the sooner someone is treated for their stroke, the better their chances for survival and potential recovery. While its not possible to prevent against every risk factor of stroke, such as age, ethnicity or family history, there are lifestyle preventions that can be undertaken. These include remaining active, maintaining a healthy weight, quitting smoking, cutting down on alcohol consumption and trying to reduce stress.

If someone is suspected of having a stroke, they will usually be given a range of diagnostic tests which include checking pulse and blood pressure and possibly carrying out blood tests, followed by an MRI or CT scan. This will give the medical team a better idea of the severity of the stroke, what type it is and which area of the brain is affected. This will then enable appropriate medication such as anticoagulants to be given, if necessary, and the formation of a treatment plan. Swallowing tests may also be carried out, as the mechanism that enables us to swallow can be badly affected by a stroke. This usually sees small amounts of water being given to a patient to see if they can manage it without choking or coughing. Other early tests include heart and blood vessel tests such as echocardiogram and carotid ultrasound.

Long-term recovery and rehabilitation

A multidisciplinary team of healthcare professionals will be in charge of your recovery once you’re being treated for stroke, and these could include physiotherapists, psychologists, occupational therapists, speech and language therapists, dietitians, and specialist nurses and doctors. Once you’re well enough to leave hospital, recovery will continue in the community with many of these professionals visiting you wherever you are rehabilitating.

There are many aspects of aftercare with stroke patients and work can be needed on all aspects of cognitive function including movement, communication, speech, mental health, spatial awareness, memory and concentration.

Having had a stroke, the chances of having another one are significantly greater, however medication can be prescribed that will help to lower high blood pressure, reduce risk of blood clots and lower cholesterol levels. Avoiding risk factors will also be encouraged, such as eating healthily, exercising regularly, stopping smoking, and drinking alcohol only within recommended limits.

Page reviewed by Carole Kerton-Church, Regional Clinical Lead on June 15, 2021