Stroke Awareness Month: why early diagnosis is vital

Every 90 seconds, someone in the UK is admitted to hospital with a brain injury. This is an alarming statistic.

Data compiled by Headway indicates that stroke accounts for a significant proportion of acquired brain injury (ABI) related hospital admissions in the UK.

A stroke is a medical emergency, and treatment for stroke is extremely time sensitive. The key treatments for acute ischemic stroke are thrombolysis and thrombectomy.

Thrombolysis is the process of giving a clot-busting drug which improves outcome after stroke by dissolving blood clots and opening up blocked blood vessels. Thrombolysis should be started as soon as possible and within 4.5 hours of the onset of stroke symptoms.

Thrombectomy is the surgical removal of a blood clot. In most circumstances thrombectomy should be performed as soon as possible and within six hours of the onset of stroke symptoms.

As a result of campaigning by charities such as the Stroke Association and promotion by the NHS, The FAST test (Facial weakness, Arm Weakness, Speech Problems, Time to call 999), for swift recognition of stroke symptoms and quick action is well known. However there are other symptoms which can indicate stroke which are not as well-known such as:

• Sudden blurred vision or loss of sight in one or both eyes.
• Sudden memory loss or confusion, and dizziness or a sudden fall.
• A sudden, severe headache.

Over the years, I have represented clients who have sustained serious and fatal injuries due to a delay in diagnosis of stroke in a clinical setting. I have had cases where the delay in diagnosis of stroke was due to mismanagement of the patients’ condition in a hospital ward. For example:

• failure to arrange a timely scan(s) of the brain
• inadequate monitoring of vital signs
• failure to competently record and escalate abnormal observations
• failure to recognise a deteriorating clinical presentation
• inadequate communication with other treating clinicians

However, we also see delays in diagnosis of stroke in patients attending Accident & Emergency departments. Despite stroke being a medical emergency, which warrants urgent attention, unfortunately stroke symptoms can go unrecognised on arrival at A&E which can lead to devastating consequences.

I currently represent a client who attended A&E with vision problems but stroke was not initially considered, which meant that my client was unable to receive thrombolysis within the 4.5 hour window and suffered life changing injuries.

With A&E waiting times at record levels, there will continue to be many more patients who will miss out on crucial and potentially life changing treatment due to a delay in diagnosing a stroke. For this reason, I believe it is of paramount importance that awareness of all key symptoms of stroke, including those outside of FAST, should be promoted amongst members of the public, health professionals and those working within a health setting (such as A&E and GP receptionists) to ensure that as many stroke patients as possible receive the urgent treatment they need.

For more information on the symptoms of stroke please visit the website of the Stroke Association.