In previous BW columns, I’ve written about how work-stress caused the stroke which I suffered in December 2013, the general dangers of work-stress and the importance of maintaining a proper work-life balance, especially in business sectors where having that balance is often sniffed at.
But what exactly is a stroke? In the time since I had mine, it has become painfully clear to me that unless someone in their close family or a close friend is afflicted, too many people know little or nothing about stroke even though it is one of the leading causes of death in the UK and, indeed, worldwide.
Essentially, a stroke is a brain attack. In the same way as a heart attack occurs when the flow of blood around the heart is interrupted, a stroke happens when the blood supply to part of the brain is cut off, killing vital blood cells.
There are three different types of stroke; an ischaemic stroke, a haemorrhagic stroke and a transient ischaemic attack. An ischaemic stroke, by far the most common type at around 75 per cent of all strokes, occurs when a blockage cuts off the blood flow to the brain.
That is often the result of clots forming in the blood and when a part of the clot breaks off, as can happen, it moves up the body to the brain and causes a blockage. Clots can be caused by all manner of things, particularly as our arteries harden and thicken with age. High cholesterol is a common cause, smoking is another but I have met and interviewed people whose stroke occurred as the result of an undetected hole in the heart. Blood flowed through the hole and got up into the brain.
A haemorrhagic stroke, the type which I suffered, is caused by bleeding in or around the brain. In my case, stress caused an artery to burst in my cerebellum, the area directly at the back of the brain which controls balance and co-ordination, among other things.
The burst artery caused blood to flow into parts of the brain it is not supposed to access, causing the intensely explosive headache I remember. If I ever get round to writing my autobiography, it will be entitled ‘The Atom Bomb in my head’. It killed large areas of brain cells, leaving me paralysed down one side for a fortnight while a painfully slow process called neuroplasticity began.
This is the ability of the brain’s billions of cells (roughly 100 billion, in fact) to find new pathways around the dead areas of the brain. They don’t replace the dead areas, they just compensate for them, which can leave survivors finding themselves with new or different skills which they didn’t possess previously.
I don’t have space here to go into neuroplasticity in any depth, but if you are interested (and you ought to be) I unreservedly recommend that you seek out a book called ‘The Brain That Changes Itself’ by Norman Doidge. This is the first book I was given by an occupational therapist as I began my rehabilitation and it is a fascinating explanation of a complex subject, written in a way that the layman with no medical knowledge can understand.
The third form of stroke, a transient ischaemic attack, or TIA, is often called a mini-stroke. It is essentially the same as a stroke, but the symptoms only last for a very short time because the blockage is temporary. Indeed, people often say that they are completely unaware of having suffered a TIA.
They are important, however because TIAs can often, but not always, be warning signs that a larger stroke could be about to happen.
How common is stroke? There are 100,000 strokes every year in the UK, a figure which was projected to rise sharply in the next few years even before the coronavirus pandemic piled added stress on to all our lives. That means a stroke happens once every five minutes and because the medical profession is more adept than ever at saving the lives of people who have strokes, there are 1.3 million survivors in the UK.
Perhaps the most important thing to know about stroke is that no two strokes are the same. Apart from the fact that I walk with a cane because my balance is so uncertain, I don’t look as if I have had a stroke. Other survivors may have badly-damaged arms or legs; others may have speech or communication difficulties or eyesight problems. The list is as endless as the brain (and specifically, what happens when it goes wrong), is fascinating. I remember someone involved in stroke rehab telling me that she had been involved in neurological research for over 30 years and still didn’t know half of what there is to know.