STROKE is the leading cause of disability in adults and one of the most common causes of early deaths. Yet I firmly believe that the vast majority of strokes are preventable, mostly simply by more effective use of existing treatments.
My colleagues and I in Oxford University’s Stroke Prevention Research Unit are working with local patients in order to turn this vision into a reality.
Your brain is the greediest organ in your body in terms of energy use.
It needs a great deal of oxygen and glucose in order to survive and function normally and it takes these nutrients from your blood.
Although your brain constitutes only about two per cent of your body weight, it demands about 25 per cent of the blood flow from your heart.
This dependency on a high blood flow has two unfortunate consequences.
First, the brain is particularly susceptible to damage when there is any loss of blood flow.
- A campaign picture showing the signs to look out for when someone is having a stroke
Second, if any blood clots form in the heart or in the large arteries that take blood from the heart, then there is a good chance that at least one will end up in the brain.
If such a blood clot is large enough to block one of the arteries in the brain, then the affected part of the brain is rapidly damaged, causing sudden loss of its particular function.
Someone may notice the sudden onset of weakness down one side, loss of speech, loss of vision, or some other neurological symptom.
If the blood clot breaks up quickly and blood flow is restored within minutes, then the symptoms usually resolve — a so-called transient ischaemic attack (TIA). If blood flow is not restored then part of the brain dies and the patient has a stroke.
This process is similar to a heart attack, in which a blood clot blocks one of the coronary arteries and damages the heart muscle.
Each year in Oxfordshire about 1,500 people have a major stroke and about 2,000 have a TIA or minor stroke.
The Stroke Prevention Research Unit at Oxford University aims to reduce the burden of stroke in the county by investigating and treating local people at the John Radcliffe Hospital, and in so doing, to carry out the research necessary to improve prevention of stroke worldwide.
The doctors and nurses working on the unit aim to provide a state-of-the-art service for patients, many of whom then generously agree to help with the research.
This type of enlightened partnership between the university, the hospital, local general practices and the public is essential if the work is to be done to improve the effectiveness of medicine for future patients.
- A campaign poster
As is often the case, the research has frequently taken unexpected turns, such as the discovery from trials of aspirin in prevention of stroke that this old drug is also effective in preventing some cancers and that it reduces the spread of cancer cells in the blood stream.
As a result, cancer researchers around the world are now studying aspirin in the treatment of cancer.
Since the unit opened in 2002, it has investigated almost 10,000 patients with TIA, stroke or other vascular events as part of the Oxford Vascular Study and other projects.
The contribution that Oxfordshire patients and their relatives have made to the research on the unit — at what is often a very difficult time for them — has resulted in over 200 research publications.
It’s a contribution that has played its full part in revolutionising many aspects of stroke prevention, saving lives across the world.
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