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What Happens In Stroke

Stroke is also known as brain attack because it occurs through a process similar to heart attack. It happens when a part of the brain does not get adequate blood supply as a result of a blocked or ruptured blood vessel, making the brain lose some of its functions. 

The human brain controls all the activities of the body including, movement, breathing, talking, memory, comprehension, heart beat, digestion and so on. The brain depends on oxygen, glucose and other nutrients in the blood to function effectively.  

The brain constitutes about 2% of total body weight, however, it uses about 20% of the total body oxygen. 

When blood supply to the brain is compromised, the part of the brain affected loses it ability to function and die off. The individual may experience long term disability such as paralysis, slurred speech, impaired memory, other forms of brain damage and in some cases, death.

Some people, especially those with hypertension, who die in their sleep may have died as a result of massive stroke. 


How Many People Are Affected By Stroke Every Year?

Every year, about 15 million people suffer from stroke worldwide. Following the stroke, about 5 million die and 5 million are left permanently disabled.11  


What Are The Types of Stroke?

There are 3 main types of stroke 

  1. Transient ischemic attack. In this type, blood supply to a specific part of the brain is cut off temporarily, functions specific to the affected area will be lost temporarily. It is different from the other 2 types because it does not last as long, loss of function is reversible, and it can be a forewarning of a future stroke. Even though it is reversible, it is a medical emergency and requires prompt attention. It may manifest inform of sudden loss of sight in one eye, inability to move any of the limbs, slurred speech and so on. The risk of stroke within the first 90 days after the first attack is about 17% and this risk is highest in the first week.10
  2. Ischemic stroke. In this type, there is blockage of the artery carrying blood to the brain usually by blood clot. It is responsible for greater than 85% of all stroke.   
  3. Hemorrhagic stroke. This happens when there is rupture of a blood vessel and subsequent bleeding into the brain. Blood flow to the area becomes inadequate and accumulated blood puts pressure on the surrounding brain tissue leading to brain injury. Hypertension is the most significant cause of brain aneurysm which can rupture causing hemorrhagic stroke.


What Are The Associated Risk Factors?  

Hypertension is the most common and important risk factor for stroke. According to the World Health Organization, Africa has the highest number of people living with hypertension. In Africa, 46% of all adults over 25 years of age have high blood pressure.3 Uncontrolled hypertension will result in damage to the blood vessels and consequently, a stroke.4

Proper hypertension control can reduce the risk of stroke by 40%. 

History of Previous Stroke. Once a person has experienced an episode of stroke, their risk of subsequent strokes increase.

Age. Stroke can occur at any age, however the risk increases with age, especially after the age of 55.

Diabetes. Stroke is one of the complications of poorly controlled diabetes. When blood glucose is persistently high, it damages the blood vessels predisposing the individual to the risk of stroke.  

Ethnicity. Individuals of African and Asian descents and people from several Eastern European countries are at relatively higher risk of stroke compared to other ethnic groups.

People of African descent experience strokes at an earlier age and don’t recover as well as individuals of other ethnicities.1,2

Smoking. When a person smokes or inhales cigarette smoke, they are exposed to nicotine and over 7,000 toxic chemicals including carbon monoxide, arsenic and cyanide. These chemicals damage the blood vessels, cause hypertension and increase one’s risk of stroke.

Risk of stroke reduces after one has stopped smoking and after 5 years of not smoking the risk of stroke is the same as in individuals who never smoked.8

Living with a smoker and inhaling cigarette smoke, also puts a person at risk of stroke.8 

Oral Contraceptive Pills. Women taking oral contraceptives are at risk of stroke and for smokers the risk is further increased.8,9,11 

Cancer: Certain types of cancers such as adenocarcinomas may increase the risk of blood coagulating in the vessels which may likely result in a stroke.

Family History. Having a parent or sibling with stroke increases an individual’s risk of stroke.

Atrial Fibrillation. Individuals with this condition have irregular or fast heart rhythm and are at a relatively higher risk of stroke. Abnormal heart rhythm can occur at any age but is more common in the elderly.7,8

Sickle Cell Disease. About 8% of children with sickle cell disease are at a risk of stroke.


Signs and Symptoms Of Stroke

This often depends on the area of the brain affected. Stroke symptoms are sudden in onset and can be life threatening. It is important to know them so you can spot them and take quick action. This may save someone’s life or even yours.

Some of these signs include:

  • Sudden weakness or inability to move the arm, leg or one side of the body.
  • Facial asymmetry, slurred speech or speech difficulty.
  • Confusion and memory impairment
  • Lack of coordination and loss of balance, dizziness
  • Inability to see through one or both eyes
  • Severe unbearable headache, especially in hemorrhagic stroke

The most effective way to recognize the signs and symptoms of stroke is by remembering the Mnemonic, F.A.S.T



F- Face: Uneven? Ask the person to smile. Does one side of the face droop?

A- Arm: Weak? Ask the person to raise both arms. Does one arm hang abnormally down?

S-Speech: Slurred? Ask the person to repeat a simple phrase. Speech slurred or strange?

T- Time: If you observe or have any of these signs, CALL FOR EMERGENCY HELP IMMEDIATELY.

You may be saving someone’s life by acting F.A.S.T!!

Note the time of the onset of symptoms as this is crucial to the treatment plan.


How Is Stroke Diagnosed?

Physical examination. Some physical signs of stroke may indicate the need for further tests to confirm.

CT scan. This is the most important test your doctor will order, especially in the immediate period, to rule out bleeding into the brain 

Laboratory tests such as complete blood count to check your blood level, blood clotting profile to study how fast your blood clots which is also important in treatment. 



Swift recognition and treatment is necessary for proper management of stroke. Note the time of the stroke if possible as this will guide your doctor in providing the most appropriate treatment.

The type of stroke will determine the treatment. Your doctor may give you medication to resolve the clot in the blood vessel, provided that there is no bleeding into the brain. 

You may also be given some medications to prevent further blood clot in the future. 


What Are The Possible Outcomes And Complications

Some stroke survivors may recover quickly while some may require long term care and support. Some of the sequelae of stroke include,  

  • Another stroke 
  • Inability to move certain parts of the body
  • Speech Difficulty
  • Brain swelling (cerebral edema)
  • Seizures
  • Clinical Depression and anxiety
  • Memory impairment and confusion.
  • Falls and Accidents
  • Pneumonia 
  • Urinary Incontinence
  • Urinary Retention
  • Erectile Dysfunction

Learn more on complications and outcomes of stroke


After Stroke Care

Physical Therapy: The purpose of physical therapy is to alleviate paralysis. The therapist will recommend the appropriate exercises to help improve balance, posture, strength and movement. 

Speech Therapy: Stroke may cause speech impairment in some people. Therapy helps with problems with speaking, understanding, pronouncing words.

Occupational Therapy: This is necessary to help the stroke survivor relearn or improve their ability to perform several activities of daily living including bathing, brushing teeth, dressing, cooking, eating, writing, reading.

Support System. Some stroke survivors will live the rest of their lives with some level of disability and functional impairment. 

These individuals will need love, care and support from close friends and family to help them get through the emotional and mental health problems.  

They will also benefit from joining a support group specifically for stroke survivors where they can share their experiences and learn from others going through similar conditions.

Recreational Therapy: This is a holistic therapy that is aimed at improving physical, cognitive, emotional and social wellness of survivors through dance, art, games and fun sports activities.

The recreational therapist will recommend certain fun activities including listening to music, crafts, swimming, yoga, horticulture and dance.          


  • Control your blood pressure
  • Manage other medical conditions that may increase your risk of stroke such as diabetes, high cholesterol levels and atrial fibrillation. 
  • Eat healthy diet
  • Exercise regularly
  • Quit smoking
  • Quit drinking alcohol
  • Take the medications prescribed by your doctor as directed

Learn more about stroke prevention

Dr Gigi

Dr Gigi is a medical doctor, an avid researcher and founder of HeLP. She is a healthy life enthusiast. She is passionate about finding better and healthier alternatives and helping to improve people's quality of life. She started Healthy Life Pantry (HeLP) with aims to provide simplified research based and proven health information, delivered by seasoned health care professionals.

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