A stroke happens when blood supply to part of the brain is interrupted due to a blocked or burst blood vessel.
This prevents the brain from getting oxygen and nutrients, causing brain cells to die within minutes. When brain cells die, the brain cannot function properly. This can cause problems with movement, sensation, speech, swallowing, vision and thinking depending on where the stroke happened in the brain.
Early diagnosis and treatment of stroke can significantly reduce the risk of long term disability – know the signs of stroke and what to do if you spot them!
Always call 995 for an emergency ambulance if you think you or someone you are with is having a stroke. The emergency ambulance crew will alert the receiving hospital so the patient can receive urgent attention in the Emergency Department when the ambulance arrives. This ensures the patient gets assessed and treated as fast as possible because every minute matters in the treatment of stroke.
There are two types of stroke.
1. Ischaemic Stroke: Blocked Artery
This occurs when an artery becomes severely narrowed or blocked, which reduces blood supply to the brain. This can be caused by a blood clot or build-up of fatty deposits in the blood vessel.
2. Haemorrhagic Stroke: Burst Artery
This occurs when a blood vessel in the brain bursts and bleeds. This prevents oxygen and nutrients from reaching brain cells beyond the burst blood vessel, causing them to die.
The risk of having a stroke increases with age, but stroke can happen at any age. Around 1 in 4 stroke occurs in Singaporeans below the age of 60 years.
80 percent of strokes can be prevented through lifestyle changes and good control of underlying medical conditions such as high blood pressure, high cholesterol and diabetes.
If you are suspected of having a stroke, you will be assessed urgently at the Emergency Department. You will have a Computed Tomography (CT) scan to identify the type of stroke, the location and its severity. Blood tests will also be done to help evaluate other causes of your symptoms and guide treatment, e.g. blood sugar levels, cholesterol and how quickly the blood clots.
Some patients may require additional tests to identify the cause of the stroke or to assist with treatment, for example:
An angiogram is an advanced x-ray of the blood vessels. It is done by inserting a small flexible tube through the blood vessels up to the brain. Dye is then delivered into the blood vessels of the brain, making them visible on the X-ray for easier identification of the location and severity of the stroke.
2. Electrocardiogram (ECG)
An electrocardiogram (ECG) records the electrical activity in the heart. It can detect underlying heart conditions that may have led to the stroke, such as previous heart attacks or irregular heartbeats (arrhythmia).
3. Carotid ultrasound
The carotid arteries are located on either side of the neck and supply the brain with oxygen and nutrients. A carotid ultrasound uses sound waves to assess the blood flow in the neck and check for narrowing or blockages in the carotid arteries.
Treatment is tailored to each patient and depends on several factors including the type of stroke, location, when it occurred, the extent of the damage and if the patient has other health problems.
Nearly all stroke survivors require months of rehabilitation, which can last up to months, to maximise their recovery so they can live as independently as possible. Long-term treatment focuses on reducing the risk of another stroke, through medication and lifestyle changes such as exercise, smoking cessation and controlling high blood pressure, high cholesterol and diabetes.
When appropriate, suitable patients who present early from stroke discovery may undergo treatment to remove the blockage and restore blood flow to the brain. This can be done via medication to dissolve the clot or a procedure to remove it. Blood thinners are commonly prescribed to reduce the risk of another stroke.
Treatment focuses on controlling blood loss and reducing pressure in the brain caused by the bleeding. This may involve a procedure or surgery and medication.
Recovering from stroke can be a long journey that affects both the stroke survivor and their family members.
Talking to people who have personally experienced a stroke and understand the challenges can help.
These organisations provide support, information and activities for stroke survivors and their caregivers:
Singapore National Stroke Association
Tel: 6222 9514
S3 - Stroke Support Station
Tel: 6473 3500 (Mon to Fri, 9.00am to 5.00pm)