Taking stroke in its stride

Strokes affect people in different ways. If you have a stroke you may not be able to move one side of your body, or you may have difficulty speaking or swallowing. A stroke happens when the blood supply to part of your brain is cut off. You will have symptoms almost immediately, which is why a stroke happens without warning.

Without a supply of blood, your brain cells won’t get enough food and oxygen. Because your brain has so many different functions, having a stroke can cause lots of symptoms. The symptoms depend on which part of your brain is affected.

What happens during a stroke? You may find that you suddenly:

*Feel weak on one side of your body. If you can’t move one side of your body at all then doctors say you have a right-sided or left-sided paralysis.

*Can’t feel anything on one side of your body. One side may feel numb.

*Have trouble speaking or understanding what is being said.

*Can’t see out of one or both eyes. You may have gaps in what you can see or you may see double.

*Feel dizzy and unsteady, and have trouble walking.

*Have problems swallowing.

*Have a terrible headache, either on its own or together with some of the symptoms mentioned above.

If you or someone you know have any of these symptoms, treat it as an emergency and get medical help straight away. The earlier you are treated for a stroke, the better your chances of making a good recovery.

Doctors may talk to you about where in your brain you’ve had a stroke. A stroke in the front of your brain (the cerebrum) will give different symptoms to a stroke in the base of your brain (in the cerebellum or the brainstem). If the stroke affects your cerebrum: Your arms or legs may be paralysed; you may have problems getting washed and dressed or understanding instructions; you may have problems with reading, writing or speaking; and you may have problems understanding what is being said.

If the stroke affects your cerebellum: You may have problems with coordination, balance and you’ll probably feel dizzy and sick. And if the stroke affects your brainstem: You may have difficulty speaking and swallowing; you may see double and feel sick; you may not be able to breathe automatically or your heart may stop beating. A stroke in the brainstem can be fatal.

Mini-strokes

If your symptoms go away within a few minutes and you recover completely, it is called a transient ischaemic attack (TIA) or mini-stroke. A TIA happens when an artery supplying blood to your brain gets blocked and the blood supply is cut off temporarily. This usually happens if the artery is blocked by a blood clot or has been narrowed by hardening of the arteries (atherosclerosis).

But this type of attack should always be taken seriously because it can mean you have a high chance of having a full-scale stroke, which could leave you with permanent brain damage. About 10 in 100 people who have a TIA will have a full-scale stroke within a week. Having treatment quickly (within 24 hours of having symptoms) can reduce this risk to 2 in 100.

It’s difficult to say what will happen to you if you’ve had a stroke. Every stroke is different. It’s especially difficult for doctors to predict what will happen to your symptoms in the first few weeks after a stroke. Once these symptoms have settled down your doctor will probably have a better idea of what kind of progress you will make. But even then there’s a lot of guesswork involved. You may find that you are still getting better months and even years after your stroke.

Depression, loss of sex drive

It’s common to feel depressed after a stroke. It’s thought that as many as 1 in 5 people get severe depression one month after their stroke. You may be particularly likely to get depressed if you have had a bout of depression before or if your stroke was bad and it’s difficult adjusting to a new lifestyle. But you have a good chance of getting over these feelings with treatment (usually with antidepressant drugs).

It’s quite safe to have sex after a stroke. But, understandably, many people feel less like having sex after a stroke, and many stop having sex altogether. Part of the problem may be the loss of feeling in one half of the body, although a stroke may simply turn some people off thinking about sex. Sexual therapy, which involves talking through any difficulties with a counsellor, may help you find ways of enjoying sex again.