Treatment

When you arrive in hospital after calling 999, a team of doctors, nurses and other healthcare professionals will assess you. 

They will ask you some questions, examine you, and check your blood pressure. They will check if you have weakness in your legs and arms.

You will also be asked to do tasks such as:

• moving your fingers
• closing your eyes
• blowing out your facial cheeks
• testing your reaction to touch

It is important to cooperate with these tests as they help determine what type of stroke you might be having, and how much it is affecting you. You may have to repeat these tests as your condition changes, to see if your condition has improved, or if it is getting worse.

They will do some investigations including blood tests, and may start you on intravenous (IV) fluids (fluids given into your vein). They will let the sickle cell team know that you are in hospital. You will also be reviewed by the stroke team. You will be admitted to a medical ward for observation.   

Brain scan

You might have a brain scan to work out exactly how your brain has been affected by the stroke. 

Blood transfusion

You may be given a blood transfusion. This will be either a simple top up transfusion, or an exchange blood transfusion (EBT). This will depend on the results of the scan and your blood tests. 

You would probably be admitted to hospital (stay overnight) if you require a blood transfusion as well as observation. You will be reviewed by doctors from the stroke team and from the sickle team. 

Other support

You might be seen by:

• physiotherapists
• occupational therapists
• speech and language therapists

They can support you if you have weakness in your limbs, or difficulties speaking.

Leaving hospital

The time you spend in hospital depends on the severity of the stroke. If needed, the physiotherapists or community nurses may visit you at home.

If your stroke has caused physical problems, a referral will be made to social services. They can assess what additional level of support you might need when you get home.

When you are discharged, you will have a follow-up appointment in the outpatients clinic. 

Preventing more strokes in the future

Having more strokes in the future is a major concern for people with SCD and their families. If your stroke is due to SCD,  and not other reasons, you will be offered a long-term transfusion programme. This is because the risk of a second stroke is very high, affecting up to half of people . This risk is decreased by having a long-term transfusion programme. 

We usually offer exchange blood transfusions, and these are done on the haematology day unit at Guy’s Hospital every 6 to 8 weeks. 

A medicine called hydroxycarbamide is sometimes used in patients who cannot tolerate a blood transfusion.

Sometimes we treat people with aspirin therapy, but this is more effective in patients who have a stroke that is not caused by SCD.