Emilia Clarke had 2 strokes in her 20s, so what causes them and how to recognise one?

Game of Thrones actress Emilia Clarke was only 24 when she suffered a stroke following a workout. Known for her role as Daenerys Targaryen in the HBO fantasy series, Clarke felt a severe headache, began vomiting and then collapsed in the bathroom of her gym. At the time, she was the definition of youthful fitness and certainly not the sort of person you would expect to have a stroke. Her type of stroke is known as a subarachnoid haemorrhage, caused by bleeding in the area between the brain and the tissues that cover it. It is often the result of a ruptured aneurysm – a ballooning section of a blood vessel with a fragile wall – as it was in Clarke’s case. It is less common than some type of strokes but not rare, estimated to cause around 5 per cent of all strokes. According to the World Health Organization, one in four adults over 25 will experience a stroke in their lifetime. Over 100 million people worldwide have had a stroke, and 1 in 5 will have a recurrent stroke within 5 years. A stroke is usually associated with getting older, but strokes are not uncommon in young people. The US Centres for Disease Control and Prevention says that 1 in 7 strokes occurs in people aged 15-49. In 2022, the University of Hong Kong’s department of medicine published a study on the incidence of strokes per 100,000 people among Hong Kong individuals aged 18-55. They found that it had risen from 39.1 in 2001 to 48.3 in 2011 to 55.7 in 2021. To put that in context, Dr Gary Lau, director of the stroke research and prevention group that was involved in the study, says that of the 15,000 new stroke cases in Hong Kong every year, about 2,300 are “young strokes”. According to Lau, the causes of strokes in younger people include cervical artery dissection, in which a tear occurs in the wall of one of the four main arteries in the neck; brain aneurysm; vasculitis, which causes inflammation in the blood vessels that supply blood to the brain and spinal cord; and the rare Moyamoya disease, in which major arteries supplying blood to the brain narrow or become blocked. Most strokes in younger people, though, are due to modifiable risk factors, such as high blood pressure, high cholesterol, diabetes, obesity and smoking, he says. Often, these conditions are newly diagnosed on admission for stroke or have been known about but not adequately managed. As we get older, we are conditioned to worry about these risks and have regular checks of blood pressure, cholesterol and blood sugar levels. Younger people are less likely to do so. Although it is easy to monitor and treat, high blood pressure is the leading modifiable risk factor of stroke, Lau says. Previous studies have shown that with every 20mmHg increase in systolic blood pressure or 10mmHg increase in diastolic blood pressure, there is a 30 to 50 per cent increased risk of stroke. A typical Chinese diet is especially high in sodium (via salt), which is directly linked to higher blood pressure. Lau says studies have found that salt intake in Hong Kong Chinese adults aged 40 to 65 is two to three times higher than World Health Organization recommendations. About 80 per cent of all strokes are preventable, Lau says – a shocking number considering the damage that strokes cause. The young are no less likely to suffer significant side effects after a stroke. Lau’s research found that in Hong Kong, at three months after a “young stroke”, about 21 per cent of people have moderate to severe disability, and about 6 per cent die. Even for those fortunate enough not to suffer long-term disability, the psychosocial consequences of young strokes are substantial, he says. About 33 per cent have moderate to severe depression, family roles and dynamics are often disrupted, and there is a significant burden on carers. The socio-economic costs are high, too, as younger family members tend to be the breadwinners, and young stroke victims may have to give up a job or education for a time, if not permanently. This will also likely affect their self-confidence and social lives. The brain’s neuroplasticity – its ability to adapt and recover – gives younger victims a chance at a faster recovery than older victims. Challenges remain in their rehabilitation, though, which is likely to include job rehabilitation, cognitive rehabilitation, relearning to drive and more, all of which require specialised expertise and resources, Lau says. As a society, we need to raise awareness of the importance of a good lifestyle and better management of modifiable risk factors starting from a young age to prevent young strokes, Lau says. This includes being mindful of diet and exercise – especially eating fewer high-salt, high-fat foods, and to do more physical activity. Obesity is a significant stroke risk, and like stroke cases among the young, it is also on the rise. The World Health Organization says obesity levels in under-30s has increased substantially, from 2 per cent of five- to 19-year-olds in 1990 to 8 per cent in 2022. Almost half of children under 5 who were overweight in 2022 lived in Asia. Smoking significantly increases the risk of stroke because it damages blood vessels and can lead to blood clots. Someone who smokes 20 cigarettes a day carries a six-fold risk of having a stroke. Lau and his team recently launched Inspire – the Initiative for Nurturing Stroke Prevention, Innovation, Rehabilitation and Empowerment – to reduce stroke numbers, especially among younger people. Clarke suffered a second aneurysm two years after her first, which also nearly killed her. She developed aphasia, difficulty speaking and writing, and significant memory issues. She did not remember her own name. She also suffered significant pain and had vision problems. Happily, with time and rehabilitation therapy, she made a full recovery. She has since set up SameYou, a charity working to develop better recovery treatment for survivors of stroke and brain injury. View this post on Instagram A post shared by @emilia_clarke BE-FAST helps to recognise stroke signs A delay in seeking care when someone has a stroke can be detrimental, Lau says. For every minute that a stroke is not treated, it has been estimated that up to 1.9 million brain neurons may be lost. Earlier stroke treatment is associated with a happier outcome. The acronym BE-FAST is commonly used to remind people of the symptoms of stroke and what to do when stroke is suspected. It stands for: Sudden loss of Balance or coordination Eye symptoms (loss of vision or seeing double) Facial weakness Arm weakness Slurring of speech, and then it’s… Time to call for help or dial emergency services Like what you read? Follow SCMP Lifestyle on Facebook, X and Instagram. You can also sign up for our eNewsletter here.

Emilia Clarke had 2 strokes in her 20s, so what causes them and how to recognise one?

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}The Game of Thrones actress had her first stroke aged 24. We talk to experts on the causes of ‘young strokes’ and how to help avoid them

The Game of Thrones actress had her first stroke aged 24. We talk to experts on the causes of ‘young strokes’ and how to help avoid them