This issue of the stroke newsletter highlights the importance of multiple risk factors of stroke. It also features a brief review of an excellent resource book ‘Stroke: A guide to recovery and prevention’, by Hachinski & Hachinski (living with stroke). The results of the National Stroke Audit suggests that major improvements are urgently needed, especially in our hospitals, if we are to significantly improve the quality of stroke care and reduce the burden of stroke. It strongly recommends that all hospitals must have specialist stroke units (acute stroke unit & stroke rehab unit) in to which all stroke patients should be admitted and cared for (stroke audit). We thank Tony Doherty for the role of an Assistant Practitioner in stroke rehabilitation. Please visit our interactive website at www.strokenewsletter.co.uk and post your views on any aspect of stroke to views@strokenewsletter.co.uk. You can also read other people’s views on the notice-board and visit other stroke web-sites through our extensive links. Do also help yourself to information leaflets on various aspects of stroke now available in our Stroke Information Racks on all Pennine Acute Hospitals Trust sites at Rochdale, Bury, Oldham and North Manchester.

Stroke has a major impact on people’s lives. Each year, 110 000 people in England and Wales have their first stroke and 30 000 go on to have further strokes. Stroke is the 3rd largest cause of death in the UK. Twice as many people in the UK die of stroke as from lung cancer, and more than three times as many women in the UK die from stroke as from breast cancer. Stroke is the biggest single cause of major disability in the UK. Stroke is preventable. Many patients and relatives do not recognize the symptoms of stroke and do not realize that seeking treatment is urgent. We can reduce the chance of a stroke by dealing with the common causes of stroke, such as smoking, excessive alcohol, poor diet, obesity, physical inactivity, high blood pressure, diabetes (high blood sugar), high cholesterol and heart disease such as irregular heart rhythm.

Stroke is an acute medical emergency and all patients require urgent admission to hospital (Acute Stroke Unit).

A Free Stop Smoking Service is now available to members of staff of North Manchester General Hospital, their family and friends who wish to stop smoking, by the Manchester Stop Smoking Service (0161 2055998). For staff or their families/friends in Oldham then please call 0161 621 5937, and for those in Bury or Rochdale please call 01706 708000.

If more than one of the risk factors for stroke applies to you, you may be running a higher risk of stroke than you realise. This is because your stroke risk factors do not just add up – they multiply up, there by increasing your chance of a stroke manifold. This means that: a smoker has 2 times the risk of stroke, who has very high blood pressure with 7 times the risk of stroke, who is also physically inactive with 2 times the risk of stroke – has a total risk of stroke which is 28 times (2x7x2) higher than an active non-smoker of the same age who has normal blood pressure. This should bring home to you how important it is to tackle any risk factors for stroke that affect you. You are also at increased risk of stroke if you have a close relative who had a stroke (a positive family history of stroke). This may be because some important causes of stroke such as high blood pressure, diabetes, and high cholesterol, tend to run in families. However, stroke is not hereditary. If you are concerned about stroke, discuss this with your doctor. Common causes of stroke include high blood pressure, smoking, excessive alcohol, diabetes, heart disease, high cholesterol, physical inactivity, drugs such as HRT, the Pill and poor diet. Have your blood pressure checked regularly if you are on the Pill. Discuss the benefits and risks of HRT with your doctor if you are on it or are considering it.

This is an excellent stroke resource book written by an internationally renowned stroke physician, and editor of the leading journal ‘STROKE’. It is written especially for the lay public, stroke survivors, and carers. Healthcare professionals and anyone else interested in stroke care would also find the book invaluable. It provides a straight forward and accessible guide to various aspects of stroke including risk factors, treatment options, stroke rehabilitation, how to rebuild your own and your loved one’s life after a stroke, and how a stroke recurrence may be prevented. The book ‘covers all aspects of stroke in a highly readable style, from understanding the possible causes, to therapy and risk factors ….A very useful read.’ (Judy Lavery, The Stroke Association).

A survey aimed at assessing levels of stroke awareness in Europe is currently on-going. The study is supported by major European stroke charities, including the Stroke Association. The results of the survey would inform how best to improve stroke awareness through health education. This would enable us to reduce the burden of stroke through more effective stroke prevention strategies. A recent UK study reported (at the European Stroke Conference, Mannheim) that many patients delay seeking medical attention following a TIA (mini-stroke) or Stroke due to lack of awareness of the symptoms of Stroke such as slurred speech, weakness, numbness, loss of ability to feel, see, swallow, maintain continence, and many other problems depending on the part of the brain that is affected by the stroke. It emphasized the importance of public education in the prevention and treatment of stroke.

The 14th European Stroke Conference will be held 25 – 28 May 2005 in Bologna, Italy –
www.eurostroke.org for more information.

North Manchester Stroke Club- Next Event-
Thurs 28 Apr 05; 7-9pm;
tel.0161681 5305 (Marion Sharkey).

National Service Framework - Stroke (Department of Health) April 2001, www.doh.gov.uk/nsf/olderpeople.htm

• Stroke Helpline (for patients discharged from NMGH)
  telephone 0161 720 2709
  
• Stroke Association
  telephone 0161 745 9222; www.stroke.org.uk
  
• Different Strokes
  telephone 0161 655 4245; www.differentstrokes.co.uk
  
• TIA / Stroke Clinic
  North Manchester General Hospital-contact Dr U Ahmed (details below)

Dr U Ahmed (Editor)

• Telephone 0161 720 2790
• FAX 0161 720 2613
• E-mail usman.ahmed@pat.nhs.uk
• Previous issues: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Tuesday 31 May 2005 12.30 – 1.30 PM,
Stroke Rehabilitation Unit (Homewood) Seminar Room, North Manchester General Hospital, Crumpsall, Manchester.

ALL WELCOME