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Diagnosis and treatment for a stroke

If you call 999 and the ambulance staff suspect a stroke, you should be taken to a large hospital with facilities to diagnose and treat stroke. On arrival at A&E you should be quickly moved to a specialist stroke unit or ward for tests to confirm whether you have had a stroke. This will ensure you receive the appropriate emergency treatment.
If you have had a stroke, you should have a scan that produces an image of your brain to show 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. 
Contact the Stroke Association for more information about what you should expect from the NHS if 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, physically and mentally, 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 over the following days and months. This is a gradual process, so 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
On a specialist stroke unit or stroke ward, you are cared for by a range of experienced health professionals - doctors, nurses, physiotherapists, occupational therapists and speech therapists - whose main job is to assess and care for people who have had a stroke and stimulate their recovery.
Staff on a stroke unit follow what is known as a ‘stroke care pathway’, this is to ensure your condition is thoroughly assessed and closely monitored and you get all the treatment and rehabilitation support you need from the appropriate health professionals. You and/or your family should be involved in developing your care plan and understand what it is hoped can be achieved within an agreed time frame.
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. 
You may be on a stroke ward for a couple of weeks or move to another ward to start your rehabilitation. Once your hospital care is finished, a further assessment of your condition should be arranged involving all relevant health professionals. This should be followed by discussion on your future care needs and the drawing up of your care plan. You and your family should play an active part at all stages of this process.
Risk of further TIAs or stroke
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  risk of further TIAs or a stroke and take appropriate action. What should happen if you have a suspected TIA is explained in the NICE guidance mentioned below. The Stroke Association also has information on how TIAs should be managed by the NHS.
Best treatment guidance
The National Institute for Health and Care Excellence (NICE) has produced guidance on the early assessment and treatment of NHS patients following a stroke or a ‘mini’ stroke. 
NICE has also produced a Quality Standard for stroke. A Quality Standard describes the level of care NHS organisations should be working towards when caring for people with a specific condition. See Help and Support for a link to this standard.

Diagnosis

If you call 999 and the ambulance staff suspect a stroke, you should be taken to a large hospital with facilities to diagnose and treat stroke. On arrival at A&E you should be quickly moved to a specialist stroke unit or ward for tests to confirm whether you have had a stroke. This will ensure you receive the appropriate emergency treatment.

If you have had a stroke, you should have a scan that produces an image of your brain to show 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. 

Contact the Stroke Association for more information about what you should expect from the NHS if 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, physically and mentally, will depend on:

  • the type of stroke you’ve hadhow bad it was andwhich parts of your brain are affected.
  • Brain cells can’t grow back but the brain has a remarkable ability to recover over the following days and months. 
  • This is a gradual process, so 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

On a specialist stroke unit or stroke ward, you are cared for by a range of experienced health professionals - doctors, nurses, physiotherapists, occupational therapists and speech therapists - whose main job is to assess and care for people who have had a stroke and stimulate their recovery.

 Staff on a stroke unit follow what is known as a ‘stroke care pathway’, this is to ensure your condition is thoroughly assessed and closely monitored and you get all the treatment and rehabilitation support you need from the appropriate health professionals.

You and/or your family should be involved in developing your care plan and understand what it is hoped can be achieved within an agreed time frame.
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. 

You may be on a stroke ward for a couple of weeks or move to another ward to start your rehabilitation.

Once your hospital care is finished, a further assessment of your condition should be arranged involving all relevant health professionals.

This should be followed by discussion on your future care needs and the drawing up of your care plan. You and your family should play an active part at all stages of this process.

Risk of further TIAs or stroke

It is important that any time you develop symptoms of a stroke or TIA you take these seriously. 3 in 10 people will go on to have another stroke or TIA, so whether you go to hospital or to your GP, your risk should be assessed.

Once this has been done you will be referred to a specialist TIA clinic (within 24 hours if you are at high risk or within a week if your risk is lower). A TIA is serious so don't ignore it. The Stroke Association has more detailed information on how TIAs should be managed by the NHS.

What should happen if you have a suspected TIA is explained in the NICE guidance mentioned below. The Stroke Association also has information on how TIAs should be managed by the NHS.

Best treatment guidance

The National Institute for Health and Care Excellence (NICE) has produced guidance on the early assessment and treatment of NHS patients following a stroke or a ‘mini’ stroke. 

NICE has also produced a Quality Standard for stroke. A Quality Standard describes the level of care NHS organisations should be working towards when caring for people with a specific condition. See Help and Support for a link to this standard.

For more information: Call Age NI Advice: 0808 808 7575

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