What is a stroke?

A stroke happens when the blood supply to a part of your brain is suddenly reduced. This prevents your brain from getting oxygen and other nutrients found in your blood.

Without oxygen or nutrients, your brain cells die. The affected area of your brain can be permanently damaged.

Most strokes are ischaemic strokes, where there is reduced blood flow to the brain due to a blood clot.

What are the signs and symptoms of a stroke?

To remember the signs of a stroke, remember the word FAST:

• Face — Has their face or mouth drooped?
• Arms — Can they lift both arms?
• Speech — Is their speech slurred? Do they understand you?
• Time is critical — If you see any of these signs, call triple zero (000) immediately and ask for an ambulance. Early treatment could save their life.

If you are having a stroke, you may experience symptoms including:

• weakness, paralysis (being unable to move) or numbness of your arm, leg or one side of your face
• slurred speech, difficulty forming words and difficulty swallowing
• trouble walking or loss of balance and coordination
• blurry vision or loss of vision in one eye
• nausea and vomiting
• severe headache
• dizziness and vertigo

Symptoms of a stroke may start suddenly or get worse over several minutes or hours. Your exact symptoms depend on which part of your brain has been affected by the stroke.

If someone near you is having a stroke, you may notice signs including:

• loss of consciousness
• sudden drooping of their mouth or eyelid on one side of their face
• trouble moving their arm or leg
• slurred speech
• trouble walking

Remember that a stroke is always a medical emergency. The longer it takes to get treatment, the more likely there will be brain damage afterwards.

Watch this video from Stroke Foundation on knowing the signs of stroke.

When should I call an ambulance or go to the emergency department?

What should I do while waiting for the ambulance?

If the person is unconscious, check their breathing and pulse and put them on their side. If there is no pulse or they are not breathing, start CPR straight away.

While waiting for the ambulance, you should:

• lay the person down on their side with their head slightly raised and supported
• loosen any tight clothing that could make it hard to breathe
• check if a limb is weak, support it and avoid pulling on it
• make sure they do not have anything to eat or drink

What causes a stroke?

A stroke happens when the blood supply to a part of your brain is suddenly reduced. This stops that part of your brain from getting oxygen and nutrients.

This can happen if:

• a blood clot blocks a blood vessel in your brain, causing an ischaemic stroke
• a blood vessel bursts and causes bleeding in your brain, causing a haemorrhagic stroke

Ischaemic stroke

There are 2 main types of ischaemic stroke:

• thrombotic stroke — when a clot or blockage forms in a blood vessel in your brain
• embolic stroke — when a blood clot forms in your heart or somewhere else in your body and travels to block a blood vessel in your brain

Ischaemic stroke is the most common type of stroke.

Haemorrhagic stroke

A haemorrhagic stroke happens when the wall of a blood vessel in your brain suddenly tears. It can also be caused by a cerebral aneurysm (a weak spot in an artery wall) bursting from sudden pressure or trauma.

There are 2 types of haemorrhagic stroke:

• intracerebral haemorrhage (ICH) — when an artery in your brain bursts and bleeds
• subarachnoid haemorrhage (SAH) — when a bleed happens in the space surrounding your brain

What will increase my risk of having a stroke?

You may be at a higher risk of having a stroke if you have had a transient ischaemic attack (TIA). A TIA is a temporary blockage of the blood supply to your brain. It causes symptoms that are similar to stroke. They often last a few minutes. You get better within 24 hours.

Risk factors for stroke that you can control include:

• smoking cigarettes
• living with high blood pressure, diabetes and high cholesterol levels
• drinking alcohol
• being inactive
• eating an unhealthy diet
• living with atrial fibrillation

Risk factors for stroke that you cannot control are:

• your age — the older you are, the greater your risk
• your sex — males are at a greater risk than females
• having a family history of stroke or some genetic disorders

How is a stroke diagnosed?

Once you are in hospital, your treating team can diagnose a stroke by:

• examining you and asking you about your symptoms
• doing blood tests
• doing an electrocardiogram (ECG) to check your heart for an unusual heart rhythm
• arranging a CT scan or MRI scan of your brain

These tests will also help your doctor diagnose what kind of stroke you are having.

How is a stroke treated?

Your treatment will depend on what caused your stroke. Treatment generally involves both immediate treatments and long-term treatments.

Immediate ischaemic stroke treatment

After your doctor has confirmed what type of stroke you are having, you may need a medicine to dissolve the blood clot causing your stroke. This is called thrombolytic therapy. It assists in quickly restoring the blood flow to your brain, to reduce any major damage.

The aim is for you to receive this medicine within 4.5 hours of your symptoms starting.

Another common treatment is a procedure called endovascular thrombectomy. A thin tube is threaded from an artery in your groin to your brain to find and remove your clot.

Sometimes brain surgery is recommended.

Your doctor may prescribe aspirin after an ischaemic stroke. They may also recommend other anticoagulant medicines (sometimes called 'blood thinners').

Immediate haemorrhagic stroke treatment

For haemorrhagic stroke, immediate treatment may involve:

• medicines to control your blood pressure
• surgery to relieve swelling in your brain

Longer-term treatment

After your initial treatment, you will begin your longer-term care that includes stroke rehabilitation. The aim of rehabilitation is to help you regain as much function as possible.

You will begin your rehabilitation in hospital. You will work with a team of therapists including physiotherapists, occupational therapists, speech pathologists and psychologists.

It's important to try and return to normal life where possible. Try to resume some kind of work and engage in your favourite activities, hobbies and interests.

Caring for someone who has had a stroke

Caring for someone who has had a stroke can take a physical and emotional toll on you.

Carer Gateway, an Australian Government program, offers free services and support for carers.

What are the complications of a stroke?

Having a stroke can cause serious long-term complications, including:

• difficulty swallowing (dysphagia)
• fatigue, weakness or lack of movement (paralysis) of one side of your body or all your limbs
• bladder and bowel incontinence
• sensory problems — changes to how things feel when you touch them
• perceptual problems — changes to how you see or understand things
• cognitive problems — difficulty thinking and remembering
• difficulty speaking (dysarthria), reading or writing

A stroke can also impact your mental health. You may struggle with your emotions after a stroke. Depression and anxiety are also common.

Depending on which part of your brain is affected, changes in your personality and behaviour can also develop. This can be very distressing for your family and close friends.

Sometimes a stroke can be fatal.

Can strokes be prevented?

To prevent a stroke, you can treat conditions that increase your risk of having a stroke, such as:

• high blood pressure
• diabetes
• high cholesterol
• atrial fibrillation

You can also reduce your risk of stroke by maintaining a healthy lifestyle, including by:

• staying active
• eating a healthy diet
• quitting smoking
• drinking alcohol in moderation

How do I lower my risk of having another stroke?

If you've already had a stroke or TIA, it is even more important you make the following lifestyle changes:

• Stay active — this helps you maintain a healthy weight and improve your health.
• Improve your diet — a diet that's varied, high in fibre, fruit, nuts, vegetables and healthy fats, but low in saturated fat and salt, can help prevent stroke.
• Quit smoking — smoking cigarettes doubles your risk of having a stroke.
• Avoid or reduce alcohol — drinking alcohol increases your risk of stroke.

Resources and support

• Call the StrokeLine on 1800 787 653 for more information and support.
• Visit the Stroke Foundation to get advice about stroke treatment, prevention and recovery.
• Visit the EnableMe website for easy-to-read resources about stroke and advice from other people who have experienced a stroke.
• If you are caring for someone who has had a stroke, visit Carer Gateway for support.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Other languages

• Call the Telephone Interpreting Service (TIS) on 131 450 and ask the interpreter to call StrokeLine on 1800 STROKE (1800 787 653).
• Watch the Stroke Foundation video, 'What is a stroke?' and read other translated fact sheets in many community languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Stroke Foundation has resources about stroke for Aboriginal and/or Torres Strait Islander people.