One in six people worldwide will have a stroke in his or her lifetime. Learn to recognize a “brain attack.”
Heart attacks often make themselves known with a hard-to-ignore, obvious symptom like chest pain. That’s not the case for strokes, which can cause a wide range of symptoms that may affect your ability to speak, see, move, or feel. A stroke interrupts blood flow to the brain, depriving brain cells of oxygen and nutrients. Prompt treatment can prevent a potentially devastating disability or death—which is why everyone should know the top warning signs of stroke.
Most strokes (about five out of six) occur when a clot blocks an artery feeding the brain (ischemic stroke). The rest happen when an artery in the brain bursts and bleeds (hemorrhagic stroke). Regardless of the cause, the resulting symptoms, which vary widely from person to person, depend on the location of the blockage or bleed, as well as how much brain tissue is affected.
Even when people are familiar with stroke symptoms, acknowledging and acting on them can be a challenge, says Dr. Natalia Rost, an assistant professor of neurology at Harvard Medical School and associate director of acute stroke services at Massachusetts General Hospital. “Some people have a psychological barrier to admitting that they may be having a stroke, because of either misunderstanding or perhaps even shame,” says Dr. Rost.
People often interpret their symptoms as being caused by something else they’re familiar with, she explains. For example, people who suddenly have trouble seeing assume they need to see an eye doctor. If they feel dizzy or can’t walk normally, they may believe they have an ear infection that’s affecting their balance.
The shame arises from the stigma associated with the consequences of stroke, says Dr. Rost. “No one wants to talk about the disability that comes with stroke, such as dragging your foot or slurring your words,” she says.
Illustration: The American Heart Association
Face drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
peech difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
Time: Time to call 911. If someone shows any of these symptoms, even if the symptoms go away, call 911 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared.
Women: Slower to seek treatment?
Gender may also affect stroke recognition and response. Last year, a study in the journal Stroke found that women having strokes were less likely than men having strokes to arrive at a hospital in time to receive clot-busting treatment. Why? Women tend to have strokes later in life than men (they were an average of four years older in the study) and consequently more likely to be living alone, according to the authors. Women may also delay seeking care because they’re usually the ones in a caregiver role and believe they can cope with their symptoms on their own, says Dr. Rost. However, men sometimes try to tough it out and also delay care for stroke.
The American Stroke Association developed the FAST guide to help people recognize the typical symptoms of a stroke. You can download a free app, Spot a Stroke F.A.S.T (for iPhone or Android) that features a video demonstrating FAST and a list of other possible stroke symptoms, which include the sudden appearance of:
numbness or weakness of a leg
confusion or trouble understanding
trouble seeing in one or both eyes
trouble walking, dizziness, loss of balance or coordination
severe headache with no known cause.
Other features include resources to learn about stroke and a 911 time stamp log. Recording the time you first notice your symptoms is important, because the clot-dissolving treatment known as tPA (if appropriate) is most effective if given within three hours.