This is the shocking truth about the rise in STROKES among young people – and all the signs that doctors are missing

Laura Akers wasn’t at all worried when she developed a nagging headache, sore neck and lingering cough last March.

Her GP prescribed antibiotics for a suspected chest infection, but as Laura, a 34-year-old assistant head teacher and mother of one from Harlow, Essex, points out: ‘It didn’t seem unusual for a working mum at the end of winter.’

She adds: ‘I had a toddler keeping me on my toes, classes to plan and life to get on with, so I didn’t overthink it.’

But then, after a busy Sunday spent crawling through soft play with her daughter Isla, two, and batch-cooking for the week, Laura suddenly became overwhelmingly dizzy. She was running a bath for Isla and had bent down to swish the bubbles, but ‘when I stood up, the room violently tilted’, she recalls.

‘My body gave way and I sank to the bathroom floor, calling out for my husband, Clark. Everything was spinning and I started being sick.’

Clark, 36, an HGV driver, helped her downstairs and rang her dad who came to drive her to hospital, while he stayed home with Isla. ‘I was lying on my dad’s lap in A&E, slurring, dizzy and vomiting into a bucket,’ says Laura.

‘It was St Patrick’s Day and the others waiting around us gave us looks as if to say, “She’s had a skinful”.’

She was given a CT scan and neurological tests, such as pointing her finger to the doctor’s as he moved it, trying to smile and providing her date of birth. But she couldn’t do any of these, let alone get the words out, while the anti-sickness drugs and fluids she was given were making no difference. The doctors were seriously concerned and blue-lighted her to Queen’s Hospital in Romford, a specialist neurology hospital some 18 miles away.

From the moment the ambulance doors were opened at Queen’s, things moved quickly.

‘Suddenly a team of medics swarmed around me, shining lights in my eyes,’ says Laura. ‘Inside, I was asked to walk and I fell down like a sack of potatoes.’

As the initial CT scan hadn’t provided any answers, Laura was given a CT angiography, which produces a detailed image of the blood vessels and tissues surrounding the brain. This revealed a tear in an artery in Laura’s neck.

‘They quickly sent me for an MRI scan, then three doctors wheeled me into a room.’

Laura was told she’d had a type of ischaemic stroke, where blood flow to part of the brain has been cut off. The torn artery in her neck had cut off blood supply to the cerebellum, the area responsible for movement, speech, balance and posture.

‘I was devastated,’ she says. ‘I begged the doctors not to let me die because I had a two-year-old who needed me.’ Laura was given anti-clotting medication and monitored for three days before she was allowed back home.

‘Before going home, I was shown my scans,’ she recalls.

‘I was shocked to see about 20 per cent white – signalling damage. I was told it was a miracle I wasn’t in ICU or on a feeding tube because of the extent of the damage, and that if I had been older, I probably wouldn’t have survived.’

There are two main types of stroke. The vast majority are ischaemic, caused by a blockage, frequently a blood clot. Around 15 per cent are haemorrhagic, where a weakened blood vessel supplying the brain bursts. Laura had a tear in the lining of an artery which caused a flap – this in turn restricted blood flow.

‘As the body tries to heal the tear, a blood clot can form, which can then block the artery at the site of the tear or travel downstream and block an artery within the brain,’ explains Professor Martin James, a consultant stroke physician at Royal Devon & Exeter Hospital. ‘Some of these tears occur as the result of physical trauma in a road accident, for example, but can also occur out of the blue without warning in otherwise healthy people like Laura.’ However, he adds that this type of tear is quite rare.

‘For most people, a stroke is the start of a life-long journey of recovery. It can be especially challenging for younger people who may have young families and jobs,’ he adds.

There is some evidence that strokes are on the rise in younger people – with a quarter of strokes in the UK, around 20,000 cases, occurring in people of working age, according to the Stroke Association.

And while the number of new stroke cases diagnosed yearly has dropped in older age groups over the last ten to 20 years, it has doubled in those under 55, say researchers from the University of Oxford, who recently launched a study to try to understand the reasons behind this rise.

The National Young Stroke Study will look at the role of traditional risk factors (such as high blood pressure, diabetes, high cholesterol level, smoking, alcohol and obesity) and emerging risk factors (such as mental health conditions, stress, long working hours and oral health) to improve prevention for this younger group.

Early detection of stroke is vital to reduce the damage and long-term impact – but this means recognising the early signs, which can be atypical, in all ages, says Professor Debbie Lowe, national clinical lead for stroke medicine and medical director at the Stroke Association.

‘Around 20 per cent of strokes affect the back part of the brain when blood flow is affected to areas such as the cerebellum, brainstem [which regulates breathing and heart rate], and certain lobes that impact vision, memory and speech.

‘These type of strokes more commonly cause symptoms such as dizziness, difficulty speaking and visual disturbance, which don’t always get picked up using the common “FAST” check,’ she explains. The acronym recognises the common signs of stroke: facial weakness, arm weakness and speech problems.

‘Therefore, it’s important for people – including healthcare professionals – to know about the less common symptoms, too.’

These include sudden memory loss or confusion, loss of balance, nausea or sickness, seizures, sudden behavioural changes, and a sudden severe headache.

If caught early, ischaemic strokes can be treated with medication to dissolve the blood clot and restore blood supply.

But these drugs have to be given within four hours of a stroke occurring in order to be effective.

If brain cells are killed off, patients can be left with disabilities and require physiotherapy and rehabilitation. ‘The ability of the brain to recover from the damage of a stroke is greater in people who are younger like Laura – but it’s a long journey of physical and psychological recovery with setbacks along the way,’ says Professor James.

‘People often need support for months or years as they try to rebuild their lives after a stroke.’

Fourteen months on, Laura still suffers with some of the effects of her stroke.

‘When I got home, I kept waking in the night with panic attacks, thinking I was having another stroke,’ says Laura.

‘And because of some brain damage, I suffer from vertigo, which is horrendous.

‘I can’t walk or stand for very long and sometimes I get so tired I can’t function.’

She adds: ‘I avoid lifting anything heavy – the heaviest thing I carry is Isla. Doctors told me not to go on roller coasters or have head or neck massages to avoid the risk of tearing an artery again.’

She has since also been diagnosed with lupus, a chronic autoimmune condition where the body mistakenly attacks tissues. This may have weakened the artery, which could have then torn from coughing and led to her stroke – but this hasn’t been confirmed.

‘During my last stroke consultation, I was told the cause was bad luck and that the artery had torn spontaneously. But I can’t help but wonder if lupus was the true cause.’

As well as medication for lupus, Laura also takes clopidogrel (a blood thinner) and a statin to reduce the risk of another stroke.

Laura has returned to work part-time, but says the biggest struggle is emotional.

‘I don’t feel like myself anymore,’ she says. ‘I’m no longer the energetic, healthy woman I used to be. I can’t chase Isla around the garden or crouch down to do colouring with her.

‘Isla says I have a “poorly brain” and likes to stroke and kiss my head to make me feel better.

‘Life looks different – but it is still filled with love, purpose and determination to live to the fullest.’