Strokes are medical emergencies characterized by the sudden interruption of blood flow to the brain, leading to potential brain damage.

Consult our neurosurgeon today for a prompt treatment plan and to improve recovery outcomes.

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Dr Keith Goh

What is a Stroke

A stroke is a condition characterised by a sudden interruption in the brain’s blood supply. This interruption can result in brain tissue damage due to the lack of oxygen and nutrients that blood provides.

The severity and the outcomes of a stroke can vary greatly depending on the extent and location of the brain affected.

Types of Strokes

Strokes are generally divided into two primary categories:

Hemorrhagic Stroke

Hemorrhagic strokes occur when a blood vessel in the brain leaks or ruptures. This type includes subtypes such as intracerebral haemorrhage, where the bleeding occurs within the brain tissue, intraventricular haemorrhage, where bleeding occurs in the brain’s ventricular system, and subarachnoid haemorrhage, where the bleeding occurs between the brain and the membranes covering it.

Acute Ischaemic Stroke (Infarct)

This type occurs when a blood clot blocks a vessel, cutting off blood supply to a part of the brain. The resulting lack of oxygen and nutrients leads to the death of brain cells in the affected area, referred to as an infarct.

Causes of Strokes

Strokes can result from various conditions affecting the brain's blood vessels:

  • Atherosclerosis: This condition involves the thickening of artery walls due to the accumulation of fatty substances, leading to blockages that can cause ischemic strokes.
  • Blood Clots: Clots forming in the brain’s arteries or elsewhere in the body and travelling to the brain are common causes of ischemic strokes.
  • High Blood Pressure: Chronic high blood pressure can strain and weaken blood vessel walls in the brain, increasing the risk of a hemorrhagic stroke.
  • Aneurysms: Aneurysms are a bulge or ballooning in a blood vessel in the brain which can rupture or leak, potentially leading to a hemorrhagic stroke.
  • Arteriovenous Malformation (AVM): AVMs are tangles of abnormal and poorly formed blood vessels that can rupture, causing hemorrhagic strokes.
  • Cavernous Angioma: This refers to a type of vascular malformation consisting of a cluster of abnormal blood vessels, typically found in the brain and spinal cord. It can lead to hemorrhagic strokes if it ruptures.

Symptoms and

Seek emergency medical attention if any of these symptoms are observed.

  • Sudden Confusion or Trouble Speaking: Difficulty in understanding speech or expressing thoughts clearly.
  • Paralysis or Numbness: This often occurs on one side of the body, affecting the face, arm, or leg.
  • Problems with Vision: Symptoms may include blurred or blackened vision in one or both eyes, double vision, or other visual disturbances.
  • Headache: A sudden, severe headache, which may occur with a hemorrhagic stroke.
  • Trouble Walking: Loss of balance or coordination, leading to dizziness or stumbling.
  • Face Drooping: One side of the face may droop or feel numb, often noticeable when the person tries to smile.


Diagnosing a stroke involves several steps to determine its type and severity:

  • Physical Examination: Initial assessment by healthcare professionals to evaluate symptoms and medical history.
  • Imaging Tests: These can help confirm a stroke and identify its type. A CT scan can detect bleeding or ischemia in the brain. An MRI scan provides detailed images of the brain to identify damaged brain tissue. Carotid ultrasounds can also be used to assess the blood flow in the carotid arteries and reveal blockages or narrowing.
  • Blood Tests: These help in evaluating factors such as blood sugar levels, infection, and clotting disorders.
  • Angiogram (MR, CT, DSA): These techniques evaluate the carotid arteries and intracranial blood flow, further assisting in stroke diagnosis.

Treatment Methods

Treatment for strokes varies depending on the type and severity. Each treatment is tailored to the individual's specific condition and the type of stroke they have experienced.

  • Craniotomy to Evacuate Haematoma: This surgical procedure involves opening the skull to remove blood clots in cases of hemorrhagic stroke.
  • Decompression Craniectomy: Used in severe cases, especially for cerebral infarction, this surgery involves removing a part of the skull to alleviate pressure in the brain.
  • Burr-Hole Insertion of Ventricular Drain: Involves drilling a small hole in the skull to drain blood or cerebrospinal fluid, often used in hemorrhagic strokes.
  • Endoscopic and Stereotactic Aspiration of Haematoma: A minimally invasive procedure to drain blood clots from the brain.
  • Craniotomy to Excise AVM and Cavernous Angioma: Surgical removal of AVMs or cavernous angiomas that may cause hemorrhagic strokes.
  • Cerebral Re-Vascularization: Procedures like EMAS, EDAS surgery, and omental transposition are used to restore blood flow to ischemic areas of the brain.
  • Aneurysm Clipping and Coiling: These include techniques to prevent blood flow into an aneurysm, reducing the risk of rupture.
  • Gamma Knife Radiosurgery for AVM: A non-invasive treatment option for AVMs, using focused radiation to shrink or obliterate the AVM.

Preventative Strategies

Several preventative strategies can help reduce the risk of stroke.

  • Managing High Blood Pressure: Regular monitoring and managing high blood pressure can aid in the early detection and timely management of strokes.
  • Maintaining Healthy Cholesterol Levels: Maintaining healthy cholesterol levels through diet or medication can reduce the risk of artery blockages.
  • Adopting a Balanced Lifestyle: This includes maintaining a balanced diet rich in fruits and vegetables, engaging in regular physical activity, and avoiding excessive alcohol consumption.
  • Quitting Smoking: Avoiding smoking is recommended due to its potential to cause nerve damage and increase stroke risk.
  • Managing Diabetes: Effective control of blood sugar levels helps in reducing stroke risk.
  • Treating Obstructive Sleep Apnea (OSA): Managing sleep apnea can reduce the likelihood of stroke.
  • Avoiding Illicit Drug Use: Substances like cocaine and methamphetamine are risk factors for stroke.

Schedule An Appointment With Us

Have You Suffered An Acute Stroke Recently?

Consult our senior consultant neurosurgeon for a prompt & personalised treatment plan.

Dr. Keith Goh






With more than 20 years of experience in the field of Neurosurgery, Dr Keith Goh’s subspecialty includes treatment of brain and spinal cord tumours and pediatric neurosurgery.

He is the Medical Director of International Neuro Associates, which is based at Mount Elizabeth Medical Centre, and provides specialist neurological services to all the hospitals within the Parkway Pantai hospital group. He also was Honorary Associate Professor of Neurosurgery at the Prince of Wales Hospital of the Chinese University of Hong Kong.

  • Bachelor of Medicine & Surgery — National University of Singapore
  • Neurosurgical Residency at the Chinese University of Hong Kong
  • Advanced specialty training in paediatric neurosurgery at the Beth Israel Institute of Neurology & Neurosurgery in New York

His bibliography includes 40 original articles, 11 book chapters, and 104 abstracts and lectures on his various research interests, such as brain tumours, spinal cord tumours, head trauma, conjoined twins and congenital malformations in children.


Mount Elizabeth Medical Centre,
#09-10, 3 Mount Elizabeth
Singapore 228510

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    Frequently Asked Questions

    Can a Stroke Lead to Permanent Brain Damage?

    Strokes can lead to varying degrees of brain damage, depending on factors such as the type of stroke, the area of the brain affected, and the duration before treatment. While some people may experience a full recovery, others might face long-term effects. Seek immediate medical attention if stroke symptoms are observed, as timely intervention can reduce the risk of permanent damage.

    Can I Walk or Exercise After a Stroke?

    Physical activity, including walking and exercise, is often a part of the stroke recovery process. The extent and nature of exercise depend on the individual’s condition. Consult your neurosurgeon or a qualified specialist for a tailored recovery programme that includes guidance on exercise and physical activity.

    What Should I Avoid Doing After a Stroke?

    After a stroke, try to avoid activities that could exacerbate your condition. These include smoking, excessive alcohol consumption, and strenuous physical exertion without medical assistance. Follow the guidance of your neurosurgeon or a qualified specialist to support recovery and prevent further strokes.