• Diseased arteries - blockage of the arteries is usually the result of athersclerosis, furring and narrowing of the artery walls with a mixture of cholesterol and other debris.
• Aneurysm - a weakened spot on an artery wall causes it to stretch. The vessel wall may become so thin it bursts, causing bleeding into the brain (haemmorhagic stroke).
• Atrial fibrillation - this kind of irregular heartbeat (arrhythmia) can cause a blood clot to form in the heart, which then travels to the brain.
• Prevention.
• While you need to take steps to stay healthy, this doesn't mean you have to start going to the gym or eating a special diet. It means getting into the habit of making healthy choices in your everyday life.It needn't be difficult if you set yourself realistic goals. Once you've got into the swing of it, you'll probably find you feel much healthier for it.

  Diet

  Too much salt (sodium) and saturated fats (found in animal fats such as red meat, cheese and butter) increase the risk of stroke, while a diet rich in fruit and vegetables (which contain antioxidants to help protect the blood vessels against atherosclerosis), unsaturated fats (found in nuts, seeds and oily fish) and fibre can help lower the risk. It has been estimated that consuming one to two servings more of fruit and vegetables a day can reduce the risk of stroke by up to 40 per cent.

  Diet checklist

  Do:
• Eat at least five portions of fruit and vegetables a day.
• Base your diet around starchy foods, such as potatoes, wholegrains (such as brown rice), couscous, pasta, yams and sweet potatoes.
• Choose low-fat meat and poultry, such as chicken, turkey, rabbit and game.
• Include oily fish, a good source of omega-3 fats, which help protect blood vessels.
• Have skimmed milk and low-fat yoghurts and cheese, such as cottage cheese.
• Save fatty, sugary foods for occasional treats.

• Consume too many fats, especially saturated fats and transfatty acids found in some margarines.
• Fry - grilling, steaming, baking or microwaving are healthier.
• Eat too many processed foods and snacks, which are usually high in salt (as well as sugar and saturated fat).

• Exercise

  Regular physical activity helps improve the condition of the heart, enhances circulation, lowers blood pressure and cholesterol levels, and helps to keep weight down, helping reduce the risk of stroke. It can also help you feel more energetic and cheerful. You don't have to join a gym. The most important kind of exercise, aerobic - the kind that gets your heart beating faster, makes you sweat and leaves you slightly out of breath - can be achieved by simply adjusting your daily routine. Walking to the shops, using the stairs instead of the lift, getting off the bus a stop earlier and going for a longer brisk walk at weekends can all improve your aerobic capacity.If you want to take it a step further you might like to take up an activity you enjoy, such as tennis, dance classes, cycling or swimming. If a stroke has affected your mobility, your doctor or physiotherapist can help devise a suitable activity plan.

  Exercise checklist

  Do:
• Check with your doctor before starting an exercise programme.
• Aim to do some form of aerobic exercise every day.
• Choose exercise suitable to your level - your doctor, physiotherapist or fitness trainer can advise.
• Try to do 30 minutes of moderately intensive exercise on at least five days a week.
• Choose an activity you enjoy - you're more likely to keep it up.

• Overdo it - small regular amounts are best. Remember, just 20 minutes walking a day reduces the risk of stroke.
• Exercise if you feel unwell or have an infection.
• Continue exercising if you feel pain, dizzy, sick or tired.

• Lifestyle

  There are various adjustments you can make to help you feel fitter and healthier and reduce your risk of stroke.Stick to safe alcohol limits. That's no more than two to three units a day for women and no more than three to four units a day for men. A unit equals half a pint of ordinary strength beer, a small glass of wine or a single pub measure of spirits.Avoid binge drinking. Drinking a lot of alcohol in a short space of time increases the risk of stroke.Know what drugs you're taking. Some medication can be affected by alcohol. Ask your doctor for information.Watch your weight. Being overweight stresses the heart and increases the risk of high blood pressure. Your doctor can tell you what's a healthy weight for you. The best way to lose weight is a low-fat diet and regular activity. You may find it motivating to join a slimming club. See your weight for advice. Stop smoking. Even if you've tried to quit before, it's worth trying again. You can use nicotine replacement therapy (NRT), complementary therapies such as acupuncture, join a stop-smoking group or attend an NHS smoking cessation clinic to increase your chances of successfully quitting. Prescription medication is also available.Stay calm. Stress can contribute to high blood pressure. Learning stress-management techniques and making time for rest and relaxation can only be good for you. This needn't be passive - yoga or meditation can help.Share your feelings. Bottling things up can make worries appear larger than they are. Sharing feelings and worries may help ease the burden.Take control. An event such as a stroke can be shocking and depressing. However, taking control of your life by doing as much as you can to reduce your risk can be a positive step and help to banish feelings of depression.Get support. There's a range of support services or people who've had a stroke.Medication. Drugs, such as anti-platelet medicines (for example, aspirin), may be recommended to prevent stroke in those thought to be at risk.
• Treatment.
• Although between 20 and 40 per cent of people who have had strokes are treated at home, research has now conclusively proved that organised stroke care in a dedicated stroke unit saves lives and reduces disability.

  Diagnosing stroke

  A number of tests may be performed to pinpoint the type of stroke and help the professionals decide on the most appropriate treatment. They may include:
• Blood pressure measurement
• Blood sampling
• X-rays
• Electrocardiogram (ECG) to assess the heart's rhythm
• Echocardiogram, to look at the heart's structure and ability to function
• Brain scans, such as magnetic resonance imaging (MRI) and computed tomography (CT), to check the kind of stroke and view the extent of damage
• Carotid ultrasound scanning or transcranial doppler ultrasonography (a type of ultrasound scan) to assess blood flow to the brain

• Anti-platelet drugs (such as aspirin), which make the blood less sticky and help reduce its tendency to clot (always consult your GP)
• Clot-dissolving drugs, if appropriate
• Anti-coagulant drugs, which reduce clotting factors in the blood so it's less likely to clot
• Cholesterol-lowering drugs to reduce high cholesterol levels
• Anti-hypertensive drugs that lower blood pressure
• Drugs designed to limit the extent of damage to the brain tissue

Surgery

• Help to aid physical recovery
• Assistance in managing the physical, emotional and social effects of stroke
• Aids and encouragement to let you become as independent as possible
• Medical help to prevent potential medical or psychological complications