Acute stroke

Also known as: sudden stroke, ischaemic stroke, haemorrhagic stroke, transient ischaemic attack (TIA)

Acute stroke occurs when the blood supply to the brain is disrupted. This can lead to serious physical and mental health problems.

What is an acute stroke?

An acute stroke starts suddenly and worsens quickly. It occurs when the blood supply to the brain is disrupted, which can injure brain cells and tissues.

Recognising the symptoms of a stroke is crucial to ensuring people get the treatment they need quickly.

Treatment within the first three hours after symptoms start gives you a better chance of a more complete recovery, even if the initial stroke is severe.

Why does the brain need a constant supply of blood?

Brain tissue is very sensitive and very active, so it needs a constant supply of blood to deliver oxygen to the thousands of nerve cells that help your body function.

If the blood supply to the brain is disrupted, even briefly, large numbers of brain cells can die within minutes.

This can cause serious damage, which can be permanent, as nerve cells in the brain cannot grow back.

This means the quicker you receive treatment to limit damage, the more likely you are to have a faster and more complete recovery.

What causes an acute stroke?

There are three main types of acute stroke, and they each have a different cause:

Ischaemic stroke

An ischaemic stroke happens when a blood vessel in the brain becomes blocked by a blood clot or fatty substances, sometimes due to atherosclerosis. This cuts off the oxygen supply to the brain.

Around 80% of people who have an acute stroke are diagnosed with an ischaemic stroke.

Transient ischaemic attack

Occasionally, a blockage in a blood vessel is only temporary. This causes a transient ischaemic attack (TIA) or ‘mini stroke’.

Symptoms can be similar to a stroke but do not last as long. They usually last a few minutes to a few hours and there is a chance they get better within 24 hours.

Haemorrhagic stroke

A haemorrhagic stroke happens when a blood vessel in the brain bursts, which makes it difficult for oxygen and nutrients to reach the nerve cells.

The blood flow can also raise the pressure inside the skull, causing further brain damage.

Can the severity of an acute stroke differ?

The severity of a stroke depends on which blood vessels are affected.

A blockage or a rupture in one of the main arteries that supplies the brain will cause widespread damage, and severe physical and mental problems.

A blockage in a minor branch of an artery will cause less damage and a full recovery is more likely.

However, this can depend on the importance of the brain cells that have been damaged.

What are the symptoms of an acute stroke?

Acute stroke often gives no warning and stroke symptoms can develop in minutes and it needs emergency medical attention.

The main symptoms of a stroke can be remembered with the word FAST:

  • Face – your face may droop to one side because of a loss of feeling or weakness.
  • Arms – the weakness and loss of movement in your face extends down the same side of your body to your arm or leg. A good test is to try to raise both your arms. Someone having a stroke will not be able to raise their arm on the affected side.
  • Speech – your speech may become slurred, or you may not be able to talk at all. You may also have problems understanding what’s being said to you and feel confused.
  • Time – if you or someone else experiences stroke symptoms, an ambulance should be called straightway.

Other symptoms

Other signs and symptoms that may happen during a stroke include:

  • A very painful headache that comes on very suddenly - many people describe it as the worst headache they’ve ever had
  • Feeling dizzy or clumsy, and being unable to walk properly
  • Finding it hard to see out of one or both of your eyes

However, there may be other causes to these symptoms, and you should see a doctor to find out what the cause may be.

What are the long-term effects of an acute stroke?

The long-term effect of an acute stroke depends on:

  • How quickly the stroke was spotted and treated
  • Which parts of the brain have been affected
  • What type of blood vessel was involved

In the most serious cases, acute stroke can lead to:

  • The loss of the ability to move parts of your body, such as part of your face, an arm or leg, or the whole side of your body
  • Difficulty remembering things
  • Finding it hard to focus
  • Problems talking, writing or reading
  • Finding it hard to change or express how you feel
  • Low mood or feeling unhappy
  • Pain that needs to be managed with regular painkillers

What can be done to prevent an acute stroke?

There’s a lot you can do to prevent having a stroke, such as:

  • Stop smoking
  • Drink less alcohol – no more than 21 units per week for men and 14 units per week for women
  • Eat fresh fruit and vegetables daily, and avoid processed foods that are high in saturated fats, sugar and salt
  • If you have diabetes, try to maintain a stable blood sugar level

How is an acute stroke treated?

Treatment for acute stroke has the greatest chance of working well if it’s given within the first three hours after symptoms start.

If you’re admitted to hospital with a suspected acute stroke, you’ll have a CT scan as soon as possible to find out exactly what’s happening in your brain.

If an ischaemic stroke is confirmed, you’ll then be given a thrombolytic drug to break down the blood clot blocking your blood vessel – a common drug is Alteplase®.

You may also get a drug to make the blood less likely to clot.

This ’thinning’ of the blood is achieved using an anticoagulant medicine such as aspirin, clopidogrel, rivaroxaban, apixaban or warfarin.

If you’ve had a haemorrhagic stroke, emergency treatment will be given to keep your blood pressure constant, reduce pressure in your skull and prevent seizures.

If the blood vessel damage is severe, you may need surgery.

Once your emergency treatment is complete and your condition stabilises, you’ll be admitted to a specialist acute stroke unit.

Most of your recovery will take place there and you’ll get help with many aspects of your life to help you get physically and mentally better.

We can also provide physiotherapy services to get you back on your feet.


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