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Subtle Stroke Symptoms Often Ignored

Few Aware of Less Obvious Stroke Warning Signs
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March 20, 2003 -- The symptoms of a stroke may be as dramatic as the sudden inability to move or talk, but more subtle signs like dizziness and numbness are just as significant and often missed, according to a new study. Researchers say failing to recognize these stroke symptoms may lead to dangerous delays in receiving medical care and render some of the most effective stroke treatments useless.

Experts say timing is critical to stroke care and reducing brain damage. Some therapies, such as clot-busting drugs that can restore blood flow to the brain and reduce stroke-related disability, may be given only within three hours of the start of stroke symptoms, according to U.S. treatment guidelines.

Major symptoms of stroke include difficulty speaking, weakness in the limbs, and loss of consciousness. But other, less dramatic symptoms may also signal a stroke:

  • Weakness in the face (such as a droopy eyelid or lip)
  • Nausea
  • Dizziness
  • Numbness
  • Loss of balance
  • Slurred speech
  • Headache

In the study, researchers examined tape recordings of emergency calls of stroke patients admitted to a German hospital over the course of a year. The calls were analyzed for mention of stroke symptoms and the length of time it took emergency response workers to respond.

The results appear in the March 21 issue of Stroke: Journal of the American Heart Association.

Researchers found speech problems were reported in about a quarter of the cases, limb weakness in 22%, and an altered state of consciousness in about 15%. A fall was the main reason for the emergency call in 21% of the cases.

But callers seldom mentioned subtle stroke symptoms. Facial weakness was cited in 10% of cases, numbness in 8%, and dizziness in about 6% of cases.

"Many patients wait to see if symptoms improve or disappear," says researcher René Handschu, MD, of the Freidreich-Alexander-Universitaet Urlangen-Nurnberg in Germany, in a news release. "From the patient's point of view, numbness of one limb or even dizziness and nausea is not so bad that you will bother all your neighbors by calling an ambulance with lights and sirens."

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