What happens after a stroke?

When you have had a stroke, you should go straight to hospital by emergency ambulance.

At hospital, you will usually be admitted to a specialist stroke ward. However, in some cases you may go to the Accident & Emergency (A&E) department or another assessment ward first.

  • Tests will confirm whether you have had a stroke and what type of stroke you have had.
  • An initial assessment will help to determine how the stroke has affected you.
  • You will start treatment immediately, as appropriate.

What tests will I have?

A brain scan is usually done straight away to determine if you have had a stroke, and if so whether it was due to a clot or a bleed. The scan will either be:

  • A CT (computerised tomography) scan - this is an x-ray of the brain and will show doctors whether your stroke was caused by a clot or a bleed and the extent of the damage the stroke may have caused.
  • An MRI (magnetic resonance imaging) scan - this is taken in a large tunnel-shaped scanner and uses a magnetic field to produce detailed images of the blood vessels in the brain.

You may also have other tests including:

  • Blood pressure checks, because high blood pressure is the biggest risk factor for stroke.
  • Blood tests to check cholesterol, blood sugar levels and to look for certain conditions that may have contributed to your stroke such as diabetes or problems with blood clotting.
  • Chest x-ray to look for underlying conditions  that may have contributed to your stroke.
  • Electrocardiogram (ECG), a recording of the electrical activity of the heart, to identify irregular heart rhythms that may have contributed to your stroke.
  • Echocardiogram, a scan of your heart to see how well your heart is working.
  • Carotid doppler scan, a scan of the arteries in your neck, to find out whether narrowing in the blood vessels in your neck may have caused your stroke.

What assessment will I have?

In the first 48 hours after a stroke, you will probably also have the following:

  • A swallowing test to make sure it is safe for you to eat or drink normally without choking
  • A mobility assessment to see whether you have difficulties moving your limbs, hands and feet
  • A communication and cognitive assessment to check whether your speech or understanding have been affected
  • A pressure risk assessment to make sure you are not at risk of pressure sores
  • A continence assessment to see if you are having difficulties controlling your bladder or bowels
  • A nutrition and hydration assessment in case you need extra fluids or dietary supplements

What treatment will I receive initially?

Your initial treatment will depend on whether you have an ischaemic or haemorrhagic stroke. Initial treatment of an ischaemic stroke (blood clot) or haemorrhagic stroke (bleed) are different but recovery and rehabilitation will be similar.

If your stroke was caused by a bleed (haemorrhagic stroke) you may be considered for surgical treatment. See the CHSS factsheet Intracerebral haemorrhage (pdf) for more information about the initial treatment of a haemorrhagic stroke.

If your stroke was caused by a clot (ischaemic stroke) you may be offered the following:

  • Thrombolysis or clot-busting treatment
  • Antiplatelets or blood-thinning treatment (such as aspirin)
  • Statins (medicines to lower your cholesterol)
  • Carotid endarterectomy (an operation to unblock narrowed arteries in your neck)
  • Decompressive surgery (to release pressure on your brain if you have severe swelling)
  • Intra-arterial clot retrieval/removal (a specialised procedure to remove the clot)
See the CHSS booklet Stroke: A Guide to Recovery in Hospital (PDF) for more information on the specific treatments and also who will be involved in your care while you are in hospital. There is also a CHSS factsheet on Carotid Endarterectomy (PDF).