Diagnosis and treatment for a Stroke

Diagnosis

On arrival at A&E, diagnosis of a stroke or TIA should be confirmed.

Once confirmed, it is necessary to find out what type of stroke you’ve had before starting treatment - bleeding into your brain (a haemorrhagic stroke) may need different treatment to one caused by a blocked artery (an ischaemic stroke).

Doctors can do this by arranging a scan that produces an image of your brain and shows where the damaged area is and what damage has been done. This might be a CT (computed tomography) scan or a more detailed MRI (magnetic resonance imaging) scan. You should have a scan within 24 hours if doctors think you've had a stroke.

Early and longer term treatment after a stroke

Each part of the brain has specific functions although the different parts also work together. How a stroke affects you, will depend on:

• the type of stroke you’ve had
• how bad it was and
• which parts of your brain are affected.

Brain cells can’t grow back but the brain has a remarkable ability to recover and parts of the brain can develop new connections. Therefore there could be potential for another part of the brain to take over some of the functions of the damaged parts.  This is a gradual process that may take months or even years. Therefore it’s difficult to know whether symptoms evident in the first few days will remain several months later.

Some common effects of a stroke are:

• weakness or paralysis on one side of your body
• difficulty swallowing (known as dysphagia)
• problems talking coherently and with reading and writing
• problems with bladder and bowel control
• memory problems and difficulty concentrating
• problems with your vision

If a relative is admitted to hospital with a suspected stroke, you may want to ask if the hospital has to a specialist stroke unit. Here you are cared for by a range of experienced health professionals - doctors, nurses, physiotherapists, occupational therapists and speech therapists - whose main job is to care for people who have had a stroke and stimulate their recovery.

Staff on a stroke unit follow what is known as a ‘care pathway’, this ensures your condition is thoroughly assessed and closely monitored and you get all the treatment you should - according to your agreed care plan - from a wide range of health professionals.

The aim of your treatment and rehabilitation programme is to help you regain, where possible, the abilities you lost as a result of the stroke and to help you and your carers adapt to life afterwards. The care pathway approach gives you the best chance of a good recovery.

Some hospital wards although not designated specialist units, follow the care pathway approach and have access to specialist staff.

You may be on a hospital unit or ward for a couple of weeks after a stroke and then move into another ward or another location for further rehabilitation.

Treatment of a TIA

Whether your symptoms prompt you to go to hospital or because the symptoms passed quickly, you opt to make an appointment with your GP, it is important to assess your future risk of a stroke and take appropriate action. What should happen if you have a suspected TIA is explained in the NICE guidance mentioned below.

Best treatment guidance

The National Institute for Health and Clinical Excellence (NICE) has produced guidance on the early assessment and treatment of NHS patients following a stroke or ‘mini’ stroke. A patient version of this guidance is available on request or can be downloaded from their website. You can find out how to contact their orderline in the Further Information section.