Know How to Spot a Stroke? Most Don't

Since mid-December 2005, Israeli Prime Minister Ariel Sharon, 77, has been hospitalized twice for stroke, including a massive one that has left him gravely ill. In contrast, Dick Clark, 76, made a bittersweet television comeback on New Year's Eve after having suffered a debilitating stroke more than one year earlier. With slurred speech, he said, "I had to teach myself how to walk and talk again. It's been a long, hard fight. My speech is not perfect but I'm getting there."

These two prominent men's medical crises have turned the media spotlight on a potentially devastating disorder. But experts lament that vast numbers of Americans still don't understand the basic facts about stroke, nor are they familiar enough with the warning signs of a "brain attack" to seek quick treatment.

In fact, public awareness of stroke symptoms lags far behind that of heart attack symptoms, several neurologists tell WebMD, even though the knowledge could be lifesaving. "People know that if they have chest pain or shortness of breath, they could be having a heart attack," says Jose Merino, MD, a neurologist and staff physician at the National Institutes of Health who conducts stroke research. "But with symptoms of stroke, people don't know them." One National Stroke Association survey estimates that one in three Americans can't name even one symptom of stroke.

Signs of Stroke

With stroke, arteries to the brain become blocked or rupture, causing brain tissue to die. Symptoms include:

• Sudden numbness or weakness of the face, arm, or leg, especially if it occurs on one side of the body
• Sudden confusion, trouble speaking, or understanding speech
• Sudden trouble seeing in one or both eyes, or double vision
• Sudden trouble walking, dizziness, loss of balance, or coordination
• Sudden severe headache with no known cause
• Drowsiness, nausea, or vomiting

If such symptoms appear, "Don't wait. Call 911 immediately," says Kyra Becker, MD, a stroke neurologist at the University of Washington Stroke Center at Harborview Medical Center in Seattle. "Every single minute counts. With each passing minute, more and more brain cells die." In other words, "Time is brain."

In some cases, a stroke is so incapacitating that a family member or bystander must call for help. Margo Warren, a spokeswoman for the National Institute of Neurological Disorders and Stroke, says, "Sometimes, the person having the stroke is the last to know what's happening."

More Stroke Education Needed

Lack of awareness plagues even groups that one would least expect, experts say. Neurologists say it's not uncommon to see people who have already had one stroke but still don't know the list of warning signs -- even though they're at risk for subsequent strokes. "They know what symptoms they had, but they can't name the rest," says Becker. Doctors are partly to blame, Merino adds. "The medical system is not doing the education."

What's more, stroke symptoms are often "negative symptoms," says Claude Hemphill, MD, MSc, an associate professor of neurology at the University of California, San Francisco, and director of San Francisco General Hospital's Neurovascular Stroke Program. "If you have crushing chest pain, you know to go to the hospital. We still see people who can't move one side of their body and wait to see if they'll feel better and they go to bed. Or they'll ask a family member to massage them and take them to the doctor if it doesn't improve."