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Keys to Recognizing a Stroke


WebMD Feature

Strokes can happen to anyone at any time, regardless of sex or age. Each year, nearly 800,000 people in the U.S. have a stroke, and 130,000 die from one. Of those who survive, more than two-thirds will have some disability. Recognizing stroke symptoms is key to preventing a needless death.

“Many patients who have a stroke develop droopiness on one side of the face. And they get weakness in the arm, so in many cases their arm falls to the side and they can’t lift it. If you ask them to smile, it’s not symmetrical,” says Holli A. DeVon, PhD, RN, an associate professor in the College of Nursing at the University of Illinois at Chicago.

In general, the best way to tell if someone is having a stroke is to use the acronym FAST, which stands for face drooping, arm weakness, speech difficulty, and time to call 911. 

If you think someone is having a stroke, ask them to smile, raise an arm, and speak a short sentence. If you see any of these signs, it's time to call 911.

Other common stroke symptoms can include the sudden onset of:

  • Numbness of the face, arm, or leg
  • Confusion, trouble speaking or understanding
  • Vision trouble in one or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • Severe headache with no known cause

When It Isn't Obvious

Knowing when a stroke has occurred can be tricky. The classic image of stroke is not being able to move on one side, or to speak. But because some strokes are less severe than others, you might feel only minor weakness in an arm or leg if you’ve had one.

There are two types of stroke; the symptoms are the same:

  • ischemic, when a blood clot blocks an artery that carries blood from the heart to the body
  • hemorrhagic, when a vessel breaks and stops blood flow to the brain

As you age, the risk for a mini-stroke -- known as a transient ischemic attack, or TIA -- rises. The symptoms of TIA mimic those of an actual stroke but go away within about 24 hours.

The likelihood that a full ischemic stroke will follow a TIA is strong -- up to 40 percent of people who have a TIA go on to have a stroke. And it doesn’t take long -- 5% of people who have TIA have a stroke within 2-3 days; 10% to 15% have one within 3 months.

Timing Is Key

Getting treatment fast is crucial. "The time component [is] similar to a heart attack," DeVon says. "You should get to the hospital as fast as possible, because there are treatments that can, in some cases, reverse the damage.”

That's thanks to a clot-busting medication -- tissue plasmogen activator, or tPa -- that can dissolve the blockages that cause ischemic strokes. But there's a catch. The medicine has to be given within 3 to 4 hours of the onset of stroke symptoms for best results. There are other medications to thin blood and prevent clotting even if the 3-hour window has passed, or if a patient can't take tPA.

Surgery to repair the broken vessel is the go-to treatment for hemorrhagic stroke.

The good news is that 80% of strokes are preventable. And since half of strokes result from high blood pressure, you can take steps to keep it in check -- quit smoking, exercise, lose weight, and take medications your doctor prescribes.

Reviewed on December 02, 2013

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