Every 5 minutes someone in the UK has a stroke. It’s the biggest cause of adult neurological disability in industrialised countries, and it accounts for about 11% of all deaths.
Role of the GP
The GP must make a rapid diagnosis and assessment of the patient who may have had a stroke or transient ischaemic attack (TIA) (features similar to stroke but lasting less than 24 hours), and make sure they receive timely referral and treatment. The GP also has a crucial role in preventing strokes, and in supporting the patient and coordinating care during rehabilitation. GP activity in preventing strokes focuses on smoking cessation advice, screening for atrial fibrillation, BP checks and monitoring, cholesterol control, weight loss and encouraging physical activity, and monitoring co-morbidities (e.g. diabetes) (for more details on preventing cardiovascular problems see Chapter 37).
History
As well as the familiar symptoms of rapid onset of unilateral weakness, speech or vision problems, patients may also present with severe headache, confusion, loss of consciousness or vomiting. Ask about:
- Risk factors for stroke, including previous strokes or TIAs, atrial fibrillation, ischaemic heart disease, diabetes, hypertension and smoking.
- Medications
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