Doctor Richard Newland, CityLivings resident health expert, on the causes of a stroke... Strokes can happen in the most bizarre of circumstances. Punk music fans have been known to overdo the head-banging and bring one on. Ladies who style were put on alert when one womans visit to the hairdressers with her head thrown back over the sink basin resulted in Beauty Parlour Syndrome and those who have unwisely dabbled in recreational drugs like cocaine and ecstasy have also been struck down. But while many of the factors that make you more likely to have a stroke can be explained, it is still not unusual for one to occur out of the blue with no obvious cause. Also like many diseases, modern living means having youth on your side doesnt necessarily rule you out of being at risk. To focus on the usual causes, high blood pressure is at the top of the list. If your blood is surging through your arteries at a higher rate than usual, the walls can be breached, especially if there is an underlying weakness. If this happens in the arteries of the brain, it can have a devastating effect and gives rise to the most serious form of stroke, known as a haemorrhagic stroke. Anything, or more specifically any habit, that contributes to high blood pressure, namely the three deadly sins, inactivity, excessive drinking and high salt intake, needs to be watched. But rather than reaching for your pulse point in a state of anxiety, you need to be sure what your blood pressure should be. Depending on your age and sex, the target should be for your blood pressure to be under 140/85. The best way to establish that you are on the right track is to ask your GP to tell you your reading as part of your next visit or if you are in a hurry, some pharmacies are offering free checks. Other stroke risk factors are high cholesterol, smoking, obesity, diabetes and heart disease especially where there is furring of the arteries as this can give rise to the other form of stroke where a blood clot forms in a clogged artery and interrupts the oxygen supply to the brain. Generally speaking men are more susceptible to stroke than women but it should be noted that there are some specific danger areas which women should be aware of. One of those is long term usage of combined oral contraceptives. The pill is fine for millions of women but for some it increases the tendency for the blood to clot which can lead to a stroke. For this reason pill users are closely monitored by health professionals and although it might not be convenient all the time to call in at the GP surgery to collect your three monthly prescription, getting that regular blood pressure check is strongly recommended. Another watch area for women is during pregnancy and at least six weeks after childbirth where hormonal fluctuations can cause the blood to become sticky. Sometimes if there have been complications during birth or surgical intervention is required, a routine heparin injection will be given to prevent clots from forming post-operatively. So how do you know if you are having a stroke? Most often it is a sudden event were a person collapses and loses consciousness, but it can develop slowly. People have been known to feel a sharp pain in their head immediately prior, possibly nausea and dizziness too. Other symptoms will depend on where the stroke occurs in the brain and the patient will experience a feeling of weakness or numbness usually only on one side of the body or confined to specific area. Often a person will find it difficult to form words and slurred speech can be an indicator. It is important that the correct diagnosis is made as occasionally the signs can be misleading and have lead some doctors to confuse symptoms to a severe migraine attack. Having a stroke can be catastrophic. 50,000 people a year die from it and many more are permanently disabled by it, hence the major campaign to target the main culprit, high blood pressure by reducing salt in the diet to 6g per day. Stroke survivors, however severely affected, certainly have a fight on their hands. The outlook for anyone who has had a stroke will be determined by the area where the stroke occurred and the size of the area affected. Recovery from a stroke can be slow process, skills like driving and speaking may have to be re-learned, affected limbs will need to put through intensive physiotherapy to regain full movement and feeling. The only really good advice that can be given is for healthy people to cut down or cut out the habits that put you at risk. For those with a pre-existing condition that makes you prone to strokes, try to manage the condition so that you minimise the likelihood of developing one. Finally, if you have a strong family history of strokes, you cant change genetics but you can resort to an old fashioned remedy of taking an aspirin a day (always check with your doctor first) to keep the blood flowing along nicely. Dr. Richard Newland is a GP at the Newhall Medical Practice the private GP surgery which serves Birmingham city centre. It offers a traditional GP service with same day appointments, unhurried consultations and no need to register. For an appointment, contact Cathy Corduff, the Practice Manager on 0121 236 6633. | 
