A stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. Damage to the brain can affect how the body works. It can also change how you think and feel. Some people make a full recovery from a stroke, others will require a significant amount of support from others to carry on with their day to day activities.

The effects of a stroke depend on where it takes place in the brain, and how big the damaged area is.

As we get older, our arteries become harder and narrower and more likely to become blocked. However, certain medical conditions and lifestyle factors can speed up this process and increase your risk of having a stroke.

There are more than 100,000 strokes each year in the UK, that means that every 5 minutes somebody will have a stroke. Over 1.2 million people in the UK have survived a stroke. About two thirds of people who have a stroke will have a long-term disability afterwards.

Around 1 in 6 men will have a stroke in their lives, around 1 in 5 women will have a stroke at some point in their lives. The average age for a stroke is in your seventies however there are over 400 childhood strokes a year in the UK.

There are 3 main types of stroke: ischaemic strokes and haemorrhagic strokes and transient ischaemic attacks. They affect the brain in different ways and can have different causes.

Ischaemic strokes are the most common type of stroke. They occur when a blood clot blocks the flow of blood and oxygen to the brain. These blood clots generally form in areas where the arteries have been narrowed or blocked over time by fatty deposits known as plaques. This process is known atherosclerosis.

As you get older, the arteries can naturally narrow, but certain things can dangerously accelerate the process.

These include:

  • Smoking 
  • High blood pressure (hypertension) 
  • Obesity 
  • High cholesterol levels
  • Diabetes 
  • Excessive alcohol intake

Another possible cause of ischaemic stroke is a type of irregular heartbeat called atrial fibrillation.

Haemorrhagic strokes (also known as cerebral haemorrhages or intracranial haemorrhages) are less common than ischaemic strokes. They occur when a blood vessel within the skull bursts and bleeds into and around the brain.

The main cause of haemorrhagic stroke is high blood pressure, which can weaken the arteries in the brain and make them prone to split or rupture.

Things that increase the risk of high blood pressure include:

  • Being overweight or obese
  • Drinking excessive amounts of alcohol 
  • Smoking
  • A lack of exercise 
  • Stress, which may cause a temporary rise in blood pressure

Haemorrhagic strokes can also occur as the result of the rupture of a balloon-like expansion of a blood vessel or abnormally formed blood vessels in the brain.

Transient Ischaemic Attacks are mini strokes. A TIA is the same as a stroke, except that the symptoms last for less than 24 hours. 1in 12 people who experience a TIA go on to have a full stroke within a week.

Symptoms of a Stroke

The signs and symptoms of a stroke vary from person to person, but they come on suddenly and a stroke is considered a medical emergency. The key symptoms can be remembered with the word F.A.S.T…

  • Face – the face may have dropped on one side, mouth or eye may have dropped
  • Arms – The person may not be able to lift both arms because of the weakness
  • Speech – Their speech may be slurred and hard to understand
  • Time – Dial 999 immediately

Other symptoms include

  • A complete or partial paralysis down one side of the body
  • Dizziness
  • Confusion
  • Loss of vision of blurred vision
  • Severe headache
  • Difficulty swallowing
  • Difficulties with balance and co ordination
  • Tiredness and difficulty concentrating

How Occupational Therapy Can Help

Occupational therapists (OTs) can help people overcome everyday difficulties and stay independent for longer by providing advice on new techniques to continue to complete everyday activities such as dressing and meal preparation for as long as possible as the condition progresses. An OT can assess you at home or in your workplace and ascertain which areas you are having difficulty with. They can then make recommendations to enable you to manage day to day tasks easier and remain independent for as long as possible. They can:

  • Advise on safer ways to manage transfers around the house, for example in / out of chairs, on / off the toilet or on / off the bed
  • Look at areas such as the bathroom and stair mobility and make longer term recommendations to ensure the home environment will meet both your short term and future needs. This includes considering adaptations such as wet rooms, adapted kitchens or through floor lifts.
  • Ensuring the correct seating, mobility aids and wheelchair are provided to maximise your function and independence. OT’s can refer onto other agencies such as a Physiotherapist for a more comprehensive mobility assessment.
  • Working with a client and their employer to advise on ways to remain at work for as long as feasible. This may involve looking at ways of travelling to work, how to maximise energy or investigate workplace changes such as the provision of equipment and minor adaptations such as rails.
  • Helping manage fatigue and tiredness by identifying priorities for the day and conserving your energy for those activities whether that be preparing dinner for the children or maintaining your work role.
  • Recommending environmental controls which allow the control of functions in the home such as opening curtains, turning on lights or the TV to be controlled from your wheelchair, armchair or bed. An OT will work with a client to identify the most suitable environmental controls for them that will preserve your independence for as long as possible.
  • An OT can show you techniques and recommend equipment to help you get in and out of your car independently. The OT may also suggest adaptations to your vehicle to keep you safe while driving.
  • An occupational therapist can support you and your family to live positively, helping you to focus on what you can do, rather than what you can’t; for example, by assisting you to establish personal goals.

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