Did you know that stroke is the leading cause of adult disability and the third most common cause of death worldwide? The acronym FAST is a simple way to recognise stroke symptoms. F stands for face: “Does one side of the face droop?” A is for arms: “Is there a problem lifting one or both arms?” S stands for speech: “Is the speech slurred?” T is for time: If all three symptoms are present, you need to rush to the hospital.

Associate Professor Deidre De Silva, Senior Consultant from the Department of Neurology at National Neuroscience Institute, gives detailed answers to your questions.

Question by foo0876a

HI Doctor

Can a very severe headache precede a stroke? Is it possible to suffer from stroke without the FAST sysmtoms?

thank you.

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

Very severe headache can precede a type of bleeding stroke called Subarachnoid Haemorrhage or SAH.

There are rarer symptoms of stroke other than those described by FAST. These include numbness over one side of the body and incoordination. Stroke may sometimes go unnoticed as the symptoms were so mild that the person was unaware of them.

Question by rsim

Hi Prof,

The acronym is useful to recognise stroke symptons, beside these, are there any other non-physical symptons we should look out for?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

The FAST acronym describes the most common symptoms of stroke. Stroke can rarely present with other symptoms including non-motor ones such as numbness on one side of the body and acute loss of memory.

Hi Prof Deidre,

Will stroke just attack us unexpectedly and sudden without any symptons?

Is there any cure for stroke?

Will surgery, medicine, acupuncture helps?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

Strokes do occur suddenly and often unexpectedly. Usually there are acute symptoms. However, stroke may sometimes go unnoticed as the symptoms are so mild that the person is unaware of them.

Question by esim

Hello Prof,

Is it that when one has stroke, soon death will follow?

what are the causes of stroke and how do we prevent stroke?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

There is a risk of death following stroke in the short and long-term. The outcome of stroke varies between individuals depending on the type and location of stroke, underlying medical conditions and patient demographics.

The two main causes of stroke are blockage of blood vessels supplying the brain and bleeding into the brain due to rupture of blood vessels.

Prevention of stroke involves control of risk factors including high blood pressure, diabetes and high cholesterol, a healthy lifestyle which includes a healthy diet, regular exercise and abstaining from smoking as well as taking medications and going for regular health appointments as advised by your doctors.

Question by kc_beary

Does numbness of hand or inavailability to use it suddenly is a symptons of stroke?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

Numbness on one side of the body can be a symptom of stroke however there can be other causes as well.

Question by esprit

Hi Professor, my mum has just been diagnoised with ruptured brain aneurysm, or subarachnoid haemorrhage. She has since gone through endovascular embolization and is recently discharged from the hospital. Is this a form of stroke? She is 50 and does not have any medical condition, like high blood pressure or diabetes. Is this genetic? Or what causes it? Is it true that aneurysm is a rare disease?

What is the chance she will have a second attack? It scares us that a healthy person can be struck by this all of a sudden and it is actually life-threatening.

Lastly, what must she do or look out for to ensure living a healthy and meaningful life? Will she be able to take part in fitness programs/sports in future? Thanks in advance.

Answered by Forum administrator

As this forum is for general discussion only, our specialists cannot provide case-specific answers. The questions above would be best addressed by the patient’s managing doctor.

Question by fong cheong

Can tiredness or lack of sleep lead to stroke ? If the patient is an elderly with high blood pressure whom tends to eat high-sodium food. When can we start acpuncture and TCM for a mild stroke patient ?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

Acupuncture and TCM are part of traditional medicine care and thus I am not in a position to comment on their efficacy and utilisation. You should consult with your medical doctor on an individual basis whether there are potential complications and interactions. A stroke patient may be on blood thinning medication with a possible risk of bleeding with acupuncture. There may be potential interactions between TCM and medications your doctor is prescribing to you.

Question by tayleehiang

High blood pressure may cause stroke how about people with very low blood pressure ? I was told it can cause stroke too is it true ?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

Very low blood pressure can be associated with stroke. This is usually in the setting of sudden drop in blood pressure for example due to heart conditions or rapid blood loss. The risk would also depend on how low the blood pressure is. If you have very low blood pressure, you should consult your doctor to find out the cause and whether there is any increase risk for consequences including stroke.

Question by mosmos

Hi Professor, does those yearly basic medical healthcheck able to detect early symptoms of stroke?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

Yearly basic medical health checks will be able to detect risk factors of stroke including high blood pressure, diabetes and high cholesterol and are thus very important for stroke prevention.

Stroke occurs suddenly and there are no early symptoms as such. Therefore health checks are not useful for detection of stroke. Should you experience symptoms of stroke, you should seek immediate medical attention at a hospital’s emergency department.

Question by octane

Dear Prof, are there any supplements or diets or exercises that we need to take note to prevent stroke?

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

A healthy diet and regular exercise are known to reduce the risk of stroke. A healthy diet is one with low salt and cholesterol intake as well as one that maintains an optimal weight. It is recommended that adults engage in 150 minutes of moderately intense exercise every week. Currently, there are no supplements proven to prevent stroke.

Question by josephine

Good evening Dr, my dad suffered from hemorrhagic stroke recently and now rehabilitating at AMK Community Hospital. I want to buy a pair of scandals or shoes for him so that he can do physiotherapy at ease without having to worry about manoeuvring the slippers.

Any idea where I can find such slippers with straps or shoes?

Thank you.

Best Regards
Josephine

Answered by Ms Marabelle Heng, Podiatrist, Department of Podiatry, Singapore General Hospital

For this purpose, sports sandals are appropriate. You may find them at sport gear shops or hiking gear shops.

Question by ktphua

Hi Prof, Lately, I experienced giddiness and head tension.I had a Glu.CHO/HDL/TG/L test on 21.09.12 and the result showed that I had a high risk cholesterol Total level. The readings of the test : Glucose,plasma 4.8 MMOL/L Alanine Transaminase, serum 24U/L Cholesterol Total,serum 6.91MMOL/L Cholesterol HDL, serum 1.84 MMOL/L Triglycerides, serum 1.13MMOL/L Cholesterol LDL, Calc 4.56MMOL/L. I was prescribed SIMVASTATIN 10MG TAB for 3 months besides taking other medicines (Omeprazole and Terazosin Tab.) I am careful on food consumption and exercise regularly (5km run) and was shock to see my health report. Will this risk lead to stroke? What are the pre-empt action to take? Please advise. Thank you very much. rdgs, ktphua

Answered by A/Prof Deidre De Silva Consultant Department of Neurology National Neuroscience Institute Neurology

High cholesterol is a stroke risk factor. However if you keep it under control with medication, a healthy diet and regular exercise, the stroke risk will be lowered. So do follow-up with your doctor to monitor your cholesterol levels to ensure there are within the target range.

Ref: T12