What is a Stroke?
A stroke (sometimes called a "brain attack") occurs when the blood supply to part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die. A stroke is a medical emergency that requires immediate treatment to minimize brain damage and potential complications.
Stroke is a Medical Emergency
Brain tissue dies every minute during a stroke. Call 1990 (Sri Lanka ambulance service) immediately if you suspect a stroke. Early treatment can save brain function and lives.
Types of Stroke
| Type | Cause | Frequency |
|---|---|---|
| Ischemic Stroke | A blood clot blocks an artery supplying the brain. The clot may form in the brain artery (thrombotic) or travel from elsewhere such as the heart (embolic). | ~85% of all strokes |
| Hemorrhagic Stroke | A blood vessel in the brain bursts (ruptures), causing bleeding into or around the brain. Often caused by uncontrolled hypertension. | ~15% of all strokes |
| TIA (Mini-Stroke) | A temporary blockage — symptoms last less than 24 hours (usually minutes). No permanent brain damage, but it is a serious warning sign that a full stroke may follow. | Warning event |
FAST — How to Recognise a Stroke
The FAST test is a simple way to recognise the signs of a stroke and remember what to do:
F
Face Drooping
One side of the face droops or feels numb. Ask the person to smile — is it uneven?
A
Arm Weakness
One arm feels weak or numb. Ask the person to raise both arms — does one drift downward?
S
Speech Difficulty
Speech is slurred or the person cannot speak or is hard to understand. Ask them to repeat a simple sentence.
T
Time to Call Emergency
If you see ANY of these signs, call 1990 immediately. Note the time symptoms started.
Symptoms of a Stroke
Stroke symptoms come on suddenly. Look out for:
- Sudden numbness or weakness of the face, arm, or leg — especially on one side of the body
- Sudden confusion or trouble understanding speech
- Sudden trouble speaking — slurred or garbled words
- Sudden vision problems in one or both eyes (blurred, double, or loss of vision)
- Sudden severe headache with no known cause (especially in hemorrhagic stroke)
- Sudden loss of balance or coordination — trouble walking, dizziness
Risk Factors
Non-Modifiable
- Age (risk increases with age)
- Family history of stroke
- Previous stroke or TIA
- Male sex (slightly higher risk)
Modifiable
- Hypertension — the #1 cause of stroke
- Diabetes mellitus
- Smoking
- Atrial fibrillation (irregular heartbeat)
- High cholesterol
- Obesity and physical inactivity
- Excessive alcohol use
- Previous TIA (mini-stroke)
The "Golden Window" — Treatment Within 4.5 Hours
For ischemic stroke (caused by a clot), there is a critical treatment window:
Clot-Busting Treatment (Thrombolysis)
A clot-dissolving drug called tPA (tissue plasminogen activator) can be given intravenously to break up the clot and restore blood flow to the brain. However, this treatment must be given within 4.5 hours of symptom onset — ideally as early as possible.
This is why noting the exact time symptoms started is crucial. The earlier the treatment, the better the outcome. Some patients may also be candidates for mechanical thrombectomy (physically removing the clot) within up to 24 hours in select cases.
What to Do If You Suspect a Stroke
Emergency Action Plan
- Call 1990 immediately (Sri Lanka ambulance service) or get to the nearest hospital with a stroke unit as fast as possible.
- Note the exact time that symptoms started — this is critical for treatment decisions.
- Do NOT give food or water — the person may have difficulty swallowing (risk of choking and aspiration).
- Do NOT give aspirin — unlike a heart attack, aspirin can worsen a hemorrhagic stroke. Let the hospital determine the type first.
- Keep the person comfortable — lay them on their side if unconscious (recovery position). Loosen tight clothing.
- Do NOT wait to see if symptoms improve — even if symptoms seem mild or temporary (could be a TIA), seek emergency care.
Prevention
- Control blood pressure: This is the single most important step. Keep BP below 130/80 mmHg. Take antihypertensive medications as prescribed — never skip doses.
- Manage diabetes: Keep blood sugar well controlled. Get regular FBS and HbA1c tests.
- Stop smoking: Smoking doubles the risk of stroke. Quitting at any age reduces your risk.
- Exercise regularly: At least 30 minutes of moderate exercise (brisk walking, cycling) at least 5 days a week.
- Eat a healthy diet: Reduce salt (less than 5g per day), eat more fruits, vegetables, and whole grains. Avoid excessive fried food and processed food.
- Treat atrial fibrillation: If you have an irregular heartbeat, see your doctor. You may need blood-thinning medication to prevent clots.
- Limit alcohol: Excessive alcohol raises blood pressure and stroke risk.
- Regular health checkups: Get your blood pressure, blood sugar, and cholesterol checked regularly — at least once a year after age 40.
- Take a TIA seriously: If you have had a mini-stroke (TIA), seek urgent medical care. Up to 1 in 5 people who have a TIA will have a full stroke within 3 months.
Important: This information is for educational purposes only. If you are unsure about your symptoms or they are severe, please consult a doctor. Our doctors are available for home visits and telemedicine consultations.