Legislative Council Fifty-Second Parliament, First Session (52-1) 52 1 Parliament of South Australia Legislative Council published Matters of Interest Stroke Awareness STROKE AWARENESS The Hon. R.P. WORTLEY Legislative Council The Hon. R.P. WORTLEY (15:32): Just last month I spoke in this place about the 2011 Tour Down Under. At that time I was not aware that three-time Tour de France winner and Adelaide contestant Alberto Contador had survived a serious stroke. I will return to Alberto's story later, but the reference is salient because I rise today to speak about one of Australia's most prevalent adverse health events, the stroke. A relative of mine recently suffered a stroke and full recovery is expected. I believe it is of vital importance to draw attention to the facts about stroke. My research indicates that stroke is the second leading cause of death for people above the age of 60 and the fifth leading cause of people aged 15 to 59. Stroke also attacks children, including newborns. The source of those statistics is the World Health Organisation. Each year 15 million people will experience strokes; nearly six million people die from stroke. According to the World Stroke Organisation (WSO), that is more deaths annually than those attributed to AIDS, tuberculosis and malaria put together. The WSO notes, too, that stroke is also 'the leading cause of long-term disability irrespective of age, gender, ethnicity or country'. Stroke is the third most common cause of death in Australia—40,000 Australians have strokes every year. Of those, 14,000 survive and recover completely. Of the remaining sufferers, 14,000 have some form of resulting disability and about 12,000 do not survive. One in six of us will suffer a stroke. So, what is a stroke? A stroke happens when there is an interruption to blood flow to the brain, either from a clot or from a ruptured blood vessel. Stroke is a medical emergency and every minute counts. The longer the blood flow to the brain is compromised, the worse the damage can be. There are two kinds of stroke. An ischaemic stroke is caused by a blood clot that occludes a vein or artery in the brain. Within only a few minutes, brain cells in the area of the stroke stop getting the oxygen and glucose they need to do their work and begin to die. If the blockage is not cleared within a few hours, the entire section of the brain which is supplied by the occluded vessel may cease to work properly and permanently. A haemorrhagic stroke is caused by the rupture of a blood vessel, causing bleeding into the brain or into the area surrounding the brain. Under pressure in the artery, blood escapes and tears at some of the soft brain tissue causing a clot that puts pressure on the surrounding brain. Brain tissue on the rim of, and adjacent to, the clot may consequently die. About one in three people who have a small warning episode known as a transient ischaemic attack (TIA) later have an ischaemic stroke. The difference between a TIA and an ischaemic stroke is that, with the former, symptoms disappear completely within 24 hours. In three of four episodes the symptoms clear within a few minutes to an hour, because the clot clears before the affected brain tissue dies. However, a TIA is a significant warning that the person is at increased risk of a future stroke. TIAs should always be reported to the doctor. Although stroke is a disease of the brain, it can affect the entire body. The effects of a stroke range from mild to severe and can include paralysis, problems with thinking and speaking and emotional problems. Patients may also experience pain or numbness after a stroke. Because stroke happens in the brain, the person may not realise that he or she is having a stroke. A passerby might think the person just looks unaware or confused. So, it goes without saying that stroke victims have the best chance if the symptoms are recognised and immediate action is taken. Being aware of the acronym FAST is an easy way to recognise and remember the signs of stroke: FAST stands for face, arms, speech and time: Face—check the person's face. Has the mouth drooped? Arms—can he or she lift both arms? Speech—is speech slurred? Does he or she understand you? Time—time is crucial. If there are any of these three signs, call the doctor immediately. Exact abilities affected by or lost through stroke depend on the degree of the brain damage and, most importantly, where in the brain the stroke occurred: the right or left hemisphere, cerebellum or the brain stem. The right hemisphere of the brain controls the movement of the left side of the body, so stroke in the right hemisphere often causes paralysis in the left side of the body. Survivors may also have issues with perceptual or spatial abilities. This may cause them to misjudge distances and fall or be unable to pick up an object, tie shoes or do up buttons. They may also become forgetful or act impulsively, which can be extremely dangerous. A left-hemisphere stroke can cause paralysis. A stroke in the cerebellum can cause abnormal reflexes of the head and torso, but brain stem strokes are particularly destructive. The brain stem controls autonomic— Time expired.