Aphasia as a stroke symptom

In awareness campaigns, it should be highlighted that aphasia can be an early and persisting symptom of stroke.

Reference: N/A
NHMRC level of Evidence: GPP

Rationale: Recognition of stroke symptoms and subsequent activation of emergency services are critical to ensuring optimal outcomes (NSF, 2010).  ‘Speech problems’ are commonly reported during ambulance calls of a stroke event but are often not associated with recognition of stroke (Mosley, Nicol, Donnan, Patrick, & Dewey, 2007). Increased recognition of aphasia as a stroke symptom by the community and emergency services, including emergency call operators, may facilitate appropriate, timely stroke care during the hyper-acute phase.

Awareness of aphasia as a stroke symptom

Poor recognition of stroke symptoms (including aphasia) are the main cause of delay in accessing emergency services (Jones et al., 2010). In Australia, only ≈ 3% of appropriate stroke patients currently receive thrombolysis, mainly as a consequence of delayed presentation to hospital (Mosley et al., 2007).

An Australian study investigating the decision to call the ambulance found that while speech and language difficulties are frequently observed, they are poorly associated as a symptom of stroke (Jones et al., 2010).

The FAST mnemonic (Face, Arm, Speech, Time) is used for public awareness of stroke in Australia, New Zealand, the UK and parts of Europe. The campaign has been shown to be successful in raising the identification of stroke with 88.9% of stroke cases identified in one cohort study (National Stroke Foundation, 2010).

RESOURCES:

Where can I learn more about  stroke and increasing stroke awareness? 

1. The National Stroke Foundation website is a great resource to find information about:

• Ways to help spread the FAST message 
• How to get involved 
• Identifying the warning signs of stroke The FAST Signs of Stroke - Stroke Foundation Australia (YouTube clip) 

References:

1. Jones, S. P., Jenkinson, A. J., Leathley, M. J., & Watkins, C. L. (2010). Stroke knowledge and awareness: an integrative review of the evidence. Age and ageing, 39(1), 11-22. doi: 10.1093/ageing/afp196
2. Mosley, I., Nicol, M., Donnan, G., Patrick, I., & Dewey, H. (2007). Stroke symptoms and the decision to call for an ambulance. Stroke; a journal of cerebral circulation, 38(2), 361-366.
3. National Stroke Foundation. (2010). Clinical guidelines of stroke management 2010,  Melbourne,  Australia

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