The word 'stroke' strikes fear into hearts of many. But is it truly that terrible? What can you do to prevent it? Can you recover from it? Assoc Prof Deidre De Silva, Head and Senior Consultant from from the Department of NeurologyNational Neuroscience Institute (NNI), a member of the SingHealth group, answer some commonly asked questions about stroke.  

If you are unsure of any of these, you can ask your doctor or another member of your healthcare team to provide you with specific details regarding your stroke.

1. What type of stroke did I suffer from?

Stroke is a condition that occurs when blood supply to the brain is interrupted. Blood carries oxygen and nutrients to the brain. When blood supply is cut off, brain cells lose their functions and this causes the signs and symptoms of stroke.

There are two main types of stroke. Haemorrhagic stroke occurs when blood leaks out of the blood vessel into the brain tissue; and ischaemic stroke when a clot blocks a blood vessel and stops blood supply to an area of the brain. You should know which type of stroke you suffered.

2. What caused my stroke?

You should have a discussion with your doctor regarding the cause of your stroke. There are many causes of stroke. Ischaemic stroke may be caused by blockage of a large or small artery, clot migration from the heart and other less common causes. Haemorrhagic stroke may be due to weakening of blood vessels due to long-standing high blood pressure, blood vessel malformations and other less common causes.

Knowing the cause of your stroke will give you a better understanding of how to reduce the risk of another stroke. In addition to knowing the cause of your stroke, you should ask your doctor to tell you your risk factors for stroke. These may include high blood pressure, diabetes, high cholesterol and smoking.

3. What can I do to decrease my risk of getting another stroke?

The strategies to reduce your risk of stroke depend on the cause and risk factors of your stroke. You should ask your doctor what specific measures can be taken in your case to reduce your chances of getting another stroke.

These may include medications, lifestyle modifications and in some instances interventional or surgical procedures. Stroke risk factors, such as high blood pressure, diabetes and high cholesterol, should be tightly controlled to decrease your chances of getting another stroke. This would involve a good diet, regular exercise, abstinence from smoking and taking medications as advised.

4. What are the medications I am taking for?

It is good to know what medications you are taking and what they are for. You should also know the specific side-effects, instructions (such as potential interactions with other medications and food) and monitoring required for each medication that you are taking.

If you suffered an ischaemic type of stroke, you will likely be on medicines that reduce blood clotting, such as aspirin. Anti-hypertensives (medicines to bring the blood pressure down), anti-lipidemincs (medicines to bring down the level of blood cholesterol), hypoglycemics (medicines to control blood sugar) may be prescribed to you, as deemed necessary by your doctor.

5. Are there any ongoing clinical trials on stroke for which I may be a good candidate?

Our understanding of stroke has grown by leaps and bounds in the past decade but scientifically proven treatments to improve the outcome following a stroke, prevent its recurrence and help with stroke recovery are still limited. Clinical trials are scientific studies which aim to collect data on how effective and safe a particular treatment for stroke is, or how accurately a test can diagnose stroke or its complications.

Participation in clinical trials is voluntary. These trials must be approved by the hospital’s ethics committee. The benefits, risks and protocol must be clearly explained to you. While you may not directly benefit from a clinical trial, you will no doubt contribute to enhancing knowledge on stroke, which can and will help you and other stroke patients in the future.

There may be ongoing clinical trials at the centre you are receiving care from that you may consider participating in.

6. What can I do to help my recovery from stroke?

One cannot predict with certainty how much and how soon you can recover. Recovery from stroke depends on the severity of the damage to your brain and your individual ability to recover from this damage and disability. It is thus very variable. Some patients recover quickly after their stroke within hours to days, while for some patients recovery may take months. The degree of recovery from stroke also differs from patient to patient. Most patients have some recovery but are left with some deficits, a small minority recover fully and some have no or limited recovery.

Participating in a stroke rehabilitation programme may increase your chances of recovery. It will also help you learn adaptive strategies to cope with your disabilities and be able to function despite your stroke. With rehabilitation, you will go through exercises that aim to help you recover from deficits as well as learn skills to adapt to your disabilities. You should be aware of the rehabilitation that you require and actively participate in this. Having a positive attitude and good support from family and friends will help you recover and improve your quality of life.

There are many potential complications following a stroke. These could delay your recovery. You should ask your doctor what complications you may be prone to, what precautions you can take to prevent them as well as the early signs of these complications.

Ref: P16