Stroke | Mate rehu ohotata

Key points about stroke

  • A stroke (mate rehu ohotata) happens when the blood supply to your brain stops suddenly. 
  • It is a medical emergency and if you think you or someone else has had one, act fast.
  • Think FAST to recognise the signs of a stroke: Face, Arm, Speech, Take action.
    • Face: Is it drooping on one side?
    • Arm: Is one arm weak?
    • Speech: Is it mixed-up, slurred or lost?
    • Take action: Call 111 immediately.
  • After a few minutes without oxygen and food from your blood, your brain begins to suffer damage.
  • If treatment is started within a few hours, permanent damage can be avoided.


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The signs and symptoms of stroke usually come on suddenly. The type of signs experienced will depend on what area of the brain is affected.

Common first signs of stroke include 1 or more of the following:

  • Face: sudden drooping, weakness and/or numbness of face
  • Arm: sudden weakness of the arm (and/or leg)
  • Speech: difficulty speaking, words jumbled or lost voice.

The T in F.A.S.T. represents the need to take action – if you think somebody might be having a stroke, call 111 immediately.

These symptoms are present in 85% of strokes.

Video: FAST campaign: Stroke Foundation of New Zealand (2018)

This video may take a few moments to load.

(Stroke Foundation of NZ, 2018)

Watch this video in Te Reo Māori.(external link)

Stroke Foundation NZ training on what a stroke is, how to recognise the key signs of stroke and how to give someone the best chance of recovery after a stroke is available through the F.A.S.T. Training and Workplace Toolkit.(external link)

Stroke refers to a sudden interruption of the blood supply to your brain, which can cause permanent damage. There are different types of stroke, described by the Stroke Foundation NZ as follows:

  • Ischaemic stroke: This is the most common type of stroke. An ischaemic stroke occurs when a clot blocks an artery in the brain. Some strokes are caused when a clot forms in a small blood vessel inside the brain that has become narrowed through high blood pressure, high cholesterol, diabetes or smoking (lacunar stroke). Some strokes are caused when a clot forms outside the brain (eg, the carotid artery or the heart) then breaks off and travels in the bloodstream to block an artery to the brain itself (embolic stroke). A common cause for carotid artery clot is atherosclerosis (build up of cholesterol and calcium deposits). A clot in the heart can be caused by some heart conditions such as atrial fibrillation.
  • Embolic stroke: This occurs when a blood clot or piece of plaque (cholesterol or calcium deposits) on the wall of an artery breaks loose and travels to the brain. When this happens, the flow of oxygen-rich blood to the brain is blocked and tissue is damaged or dies.
  • Haemorrhagic stroke: This occurs when an artery in the brain ruptures (bursts) and leaks blood into the brain (cerebral haemorrhage). This break in the blood pipeline means parts of the brain are deprived of blood and a stroke occurs. Blood irritates brain tissue, causing swelling and pressure, which cause further damage and loss of function. Subarachnoid haemorrhage (SAH) is when blood leaks into the surface of the brain. Intracranial haemorrhage (ICH) is when there is bleeding into the brain tissue itself.

Video: What is a Stroke? (HealthSketch)

This video may take a few moments to load.

(Health Sketch(external link), UK, 2015)

Each year about 9,000 people in New Zealand have a stroke. Strokes are more common as you get older, with 76% of strokes occurring in people over the age of 65 years. However, they can occur in younger adults and even children on rare occasions. 

About 80% of strokes are preventable, so check with your doctor, nurse or pharmacist as to what your risk is and what you can do to reduce it.

Risk factors for stroke

Check your risk with the Stroke Riskometer app developed by the Auckland University of Technology, NZ, 2015.

To diagnose a stroke, ambulance and medical teams will ask you a series of questions. These will be about your symptoms, when they started, whether you have any other health conditions, etc. They will also use some standard assessment tools to help assess how urgently you need treatment. 

If a stroke is suspected, further tests will be done, such as:

  • blood tests to check your full blood count, electrolytes, renal function tests, fasting lipids, erythrocyte sedimentation rate and/or C-reactive protein and glucose
  • electrocardiogram to check your heart rhythm
  • head CT scan 
  • possibly additional investigations, eg, angiography, chest x-ray, syphilis serology, vasculitis screen, prothrombotic screen and Holter monitor.

These tests should be performed as soon as possible after a stroke. In some cases they may need to be performed as an emergency procedure.

The symptoms you have in the first few days after a stroke may not last forever. If your symptoms are going to improve, they usually do so in the first 2 months after you have a stroke. In many cases, if treatment is received early enough, full recovery is possible. 

Early treatment is critical

Time is brain – meaning every minute counts and the longer brain cells are without oxygen, the more damage that is done. If treatment is started within a few hours, more brain cells can be saved. 

Where possible, stroke patients are now treated within specialist stroke units. In most cases, treatment includes medication, rehabilitation and lifestyle changes.

In the acute phase:

  • Medicine may be given intravenously to help dissolve blood clots (acute stroke thrombolysis).
  • Sometimes surgery is needed to treat brain swelling or help reduce further bleeding in cases of haemorrhagic strokes.

In the recovery phase:

  • Medication is given to lower blood pressure and reduce cholesterol levels.
  • Depending on the type of stroke and parts of the body affected, a range of rehabilitation support may be needed for weeks to months. 
  • Rehabilitation support can range from speech and language therapy to physical therapy and work retraining.
  • Lifestyle changes are also needed as above to improve diet and exercise levels, support quitting smoking, managing stress and more. 

If you are at higher risk of having a stroke or have had one, talk with your doctor, nurse or pharmacist about what you can do to lower this risk.

Key steps include:

Read more about how to reduce your risk of stroke.

Fatigue (excessive tiredness) affects up to 92% of people who have had a stroke. It's normal to get tired after a busy day or not sleeping well the night before. This usually gets better after a good night's rest.

However, fatigue after stroke is an excessive tiredness that will not go away even after a good rest or sleep. You may feel constantly worn out, or have no energy to carry out usual daily activities. 

Causes of fatigue after stroke

It is unclear why you get excessive tiredness after experiencing a stroke. It could be caused by a combination of factors, such as:

  • brain damage due to stroke
  • stress after having a stroke
  • difficulty adjusting to your new life situation.

There are also a number of medical problems that could contribute to excessive tiredness after stroke. These include:

  • diabetes
  • anaemia
  • insomnia
  • sleep apnoea
  • thyroid problems
  • depression
  • medications that have fatigue as a side effect
  • poor diet.

See your doctor if you have excessive tiredness after stroke so that they can check if you have any of these medical problems. 

Top tips to cope with fatigue after stroke

There are a number of things you can do to help cope with excessive tiredness after a stroke. These include to:

  • exercise regularly
  • eat well
  • drink plenty of water 
  • sleep well
  • avoid alcohol
  • keep a diary on how much you are doing and discuss this with your doctor
  • do regular activities in a day 
  • ask for help when you need it.


Here are a few personal stories about individuals who have been through stroke. Despite the mountain of troubles and problems caused by stroke, these courageous people continue to live joyful and productive lives.

Video: Know the Signs of a Stroke Think FAST – Dianna’s story

"Dianna, a health worker who is Ngāpuhi, experienced a stroke one morning. Fortunately she knew the signs and got help fast. Because of this she has recovered well. Dianna knew she was at risk, given she was a long time smoker and overweight. She has made some changes now, and that day she had her last cigarette." This video may take a few moments to load.

(Ministry of Health, NZ, 2018)

Video: Know the Signs of a Stroke Think FAST – Kaumolangi’s story

"Father of five children and just 29 years old, Kaumolangi had a stroke. Thanks to his mother in law, who knew the signs of a stroke and acted fast, he has fully recovered. Think FAST - FACE drooping, ARM weakness. SPEECH difficulty, TIME to call 111." This video may take a few moments to load.

(Ministry of Health, NZ, 2017)

Southern DHB Patient Video: Daphne

Daphne suffered a stroke and was in hospital for nine weeks. She was determined to go home and with the support of Southern DHB, she was able to. Watch Daphne’s story to find out more about her patient journey through Southern DHB. This video may take a few moments to load.

(Southern DHB, NZ, 2018) 

Video: Viewpoint of a stroke survivor

Stroke survivor Rob provides a quick insight into his life and his use of Stroke Foundation of New Zealand services. This video may take a few moments to load.

(Stroke Foundation of NZ, 2015)

Video: Living well after stroke with Jacqui & Murray Hynd

Murray and Jacqui Hynd's lives changed dramatically after Jacqui had a severe stroke in 1995. They talk about their new approach and outlook toward life, the importance of a sense of humour, maintaining new and exciting challenges and more. This video may take a few moments to load.

(Health Navigator Charitable Trust, NZ, 2015)

Relearning Life – Jacqui Hynd's story(external link) Able Magazine, UK
Jacqui's website(external link) has more about her experiences, and videos on how she has learned to do things differently and maintain her independence after her stroke.

Video: WOF4 Episode 6 - Stroke Part 1 of 3 Rukingi's story

Like many of us, Rukingi worked 24/7, pushing himself at the expense of his health. Unfortunately, Rukingi’s experience reinforces the horrifying statistics that pin the average age of stroke occurrence in Maori to 56 years old – a conspicuous 15 years earlier than Pakeha. This video may take a few moments to load.

(Faultline Films, NZ, 2010)

Video: WOF4 Episode 6 - Stroke Part 2 of 3 Rukingi's story

This video may take a few moments to load.

(Faultline Films, NZ, 2010)

Video: WOF4 Episode 6 - Stroke Part 3 of 3 Rukingi's story

This video may take a few moments to load.

(Faultline Films & Te Mangai Paho, NZ, 2010)

Video: 1995 AVM Stroke Survivor Rise Above the Challenge / Jacqui Hynd 15 Longterm Condition

"Rehab participation: Jacqui turns disability into capability." This video may take a few moments to load.

(Murray Hynd, NZ, 2017)

More videos: 

If you or someone you know has had a stroke, visit Stroke Foundation of NZ(external link) 0800 STROKE (0800 78 76 53). The Stroke Foundation provides a wide range of support, including support groups and educational resources. 

Community Stroke Advisors(external link) are available throughout most of New Zealand to work with stroke survivors, their family, whānau and carers. Their role ensures people achieve the best possible outcome after stroke. This service is free.

Communicating after stroke(external link) Resources for Māori whānau affected by communication difficulties after stroke.

Family and stroke(external link) A new online support platform to help tamariki who have whānau who have experienced a stroke. This website is part of the Stroke Foundation of New Zealand.

New Zealand Sign Language videos about stroke, produced by Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ.

These videos are NZSL translations of Healthify pages on stroke

Stroke – overview

(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, 2022)
Visit our stroke key points information.

What are the symptoms of a stroke?

(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, 2022)
Visit our what are the symptoms of stroke information.

Who is at risk of having a stroke?

(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, 2022)
Visit our who is at risk of having a stroke information.

How is a stroke diagnosed?

(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, 2022)
Visit our how a stroke is diagnosed information.

What is the treatment for stroke?

(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, 2022)
Visit our what is the treatment for stroke information.

How can I reduce my risk of stroke?

(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, 2022)

Stroke information(external link) Stroke Foundation of NZ
F.A.S.T. training and workplace toolkit(external link) Stroke Foundation of NZ
NZSL videos about stroke (or see below) Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022 
Communication after stroke(external link) Information and support for Māori whānau with communication difficulties caused by stroke
Jacqueline Hynd's personal story – living well after stroke(external link) Day by Day – Karen Day's blog
Haemorrhagic stroke – explained(external link) American Heart Association
Ischaemic stroke – explained(external link) American Heart Association


Many resources below are from the Stroke Foundation of NZ. Most of them can be downloaded as pdf files. To order paper copies, email or phone 0800 78 76 53. They will be delivered free within New Zealand.


Life after stroke – book(external link) The essential information resource for people with a stroke, their families and caregivers. (Available as a 208 page spiral bound paperback or as an ePub download.) 

Kaupapa Māori resources

For further details about the above kaupapa Māori resources contact Nita Brown on 04 815 8970 or 027 556 9997. For more kaupapa Māori stroke information visit the He Ūpoko Tapu Stroke Prevention page(external link) from the Stroke Foundation NZ.

For more Pacific translations and information see the Stroke Foundation NZ's Pacific Stroke Prevention Project.(external link) 



  1. NZ clinical guidelines for stroke management 2010(external link) Stroke Foundation NZ, 2010
  2. Projected stroke volumes to provide a 10-year direction for NZ stroke services(external link) NZ Medical Journal 2018 Jun 22;131(1477).
  3. Facts about stroke in NZ(external link) Stroke Foundation NZ
  4. Fatigue after stroke fact sheet(external link) Stroke Foundation NZ

Clinical pathways

The Australian and New Zealand clinical guidelines for stroke management(external link) Stroke Foundation, NZ, 2022

Other resources

Time is brain – emergency treatment of stroke – early assessment and management(external link) BPAC, NZ, 2010
Carotid stenting – a stroke of genius?(external link) IME Video Library – University of Wisconsin School of Medicine and Public Health, US, 2015   
The use of antithrombotic medicines in general practice(external link) BPAC, NZ, 2011
F.A.S.T. training and workplace toolkit(external link) Stroke Foundation NZ, 2022
New Zealand Out-of-Hospital Acute Stroke Destination Policy Northland and Auckland Areas(external link) 

Continuing professional development

Webinar: Strokes in the Wild(external link) Dr Joseph Donnelly, MBChB, PhD. Advanced trainee in Neurology

This presentation covers:

  • Identification of key features and risk profiles for stroke
  • New developments in acute stroke treatments
  • Emergency triage of stroke-like presentations
  • Outpatient management of cerebrovascular disease

Video: MHH - Strokes in the wild

You can watch the video, answer questions and claim hours with a certificate. This video may take a few moments to load.

(My Health Hub, NZ, 2023)



communication after stroke booklet

Communication after stroke booklet

Karen Brewer, Clare McCann and Matire Harwood, 2020

screenshot 2022 07 19 222123

Blood pressure & stroke

Stroke Foundation, NZ

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Helen Kenealy, geriatrician and general physician, CMDHB

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