Signs of Stroke and What to do Next

Strokes are serious business: they are the fourth leading cause of death in Americans and a leading cause of disability in stroke survivors over 65¹. Also referred to as a “brain attack,” a stroke is caused by the sudden loss of oxygen-rich blood flowing to the brain. When this happens, brain cells deprived of oxygen die. The longer a stroke goes untreated, the more cells die, causing more severe — often permanent and irreversible — damage.

While some people do recover completely from strokes, more than two-thirds of survivors all have some type of disability². Knowing the signs of stroke and acting fast can make an enormous difference in outcomes.

Who is at risk of a stroke?

As with many other medical conditions, strokes have both controllable and uncontrollable risk factors, such as lifestyle habits and age, respectively. Here are some of the main contributors to stroke:

• High blood pressure
• Diabetes
• Heart and blood vessel diseases such as coronary heart disease, atrial fibrillation, heart valve disease, and carotid artery disease
• High LDL cholesterol levels
• Smoking
• Viral infections or conditions that cause inflammation, such as lupus or rheumatoid arthritis
• Medical conditions, such as certain bleeding disorders, sleep apnea, kidney disease, migraine headaches, and sickle cell disease
• Anxiety, depression, and high stress levels 
• Living or working in areas with air pollution
• Blood-thinners or other medicines that can lead to bleeding
• Unhealthy lifestyle habits, including eating unhealthy foods, not getting regular physical activity, drinking alcohol, or using illegal drugs
• Obesity or carrying extra weight around your waist and stomach

Uncontrollable or unchangeable factors

• Age: Although strokes can occur at any age, the risk increases with age. After 55, many people develop atherosclerosis, or plaque in the arteries. As you age, some of this plaque can break loose, clog the artery, and cause a stroke.
• Sex: At younger ages, men are more likely than women to have a stroke. But women tend to live longer, so their lifetime risk of having a stroke is higher.
• Race and ethnicity: In the United States, stroke occurs more often in African American, Alaska Native, American Indian, and Hispanic adults than in Caucasians.
• Family history and genetics: Your risk of having a stroke is higher if a parent or other family member has had a stroke, particularly at a younger age.

What are the signs of a stroke?

When recognized early and treated quickly and professionally, strokes need not necessarily be catastrophic. In fact, when caught and treated early, outcomes can be very positive.  

Here are 10 signs of someone having a stroke. A person will likely have sudden onset of several of these signs, but not necessarily all:

1. Asymmetrical face, drooping on one side
2. Body numbness
3. Severe and sudden headache
4. Confusion, trouble finding words
5. Sight issues, trouble with depth perception, squinting, blinking, problem reading
6. Sudden dizziness, lightheadedness
7. Loss of balance and coordination
8. Difficulty walking, unsteady
9. Trouble talking, can’t repeat simple phrases
10. Panic, as a result of the previous symptoms

Note: The signs of a stroke in women are generally very similar to those in men, except they can be more subtle. Women may, for example, experience headaches and disorientation just like men, but they may also feel a general weakness or fatigue which may be accompanied by nausea or vomiting.

Mini strokes and silent strokes

A mini stroke is technically known as a Transient Ischemic Attack (TIA). Typically, it lasts between a few minutes and 24 hours and doesn’t cause permanent damage. But it is nothing to be ignored. A mini stroke is an early warning that a more serious stroke awaits. Don’t be lulled into complacency. Up to one-third of people who have a TIA go on to have a more severe stroke within one year.³ Prompt treatment for a mini stroke can reduce your risk of having a major stroke.

It is also possible to have a stroke without realizing it. These are called Silent Strokes. Usually, the only evidence of a silent stroke is found while undergoing a magnetic resonance imaging (MRI) test for another condition. Patients often do not even remember having any symptoms. A mini stroke, by contrast, is a brief but memorable event.

What to do if someone is having a stroke

The suddenness of the onset of stroke symptoms and the critical importance of fast treatment makes it vital to know what to do next. The more you know, the faster you can act, and the better the outcome can be. The first three hours are key so don’t delay.

Here are three things TO DO:

1. Conduct the F.A.S.T. test. The F.A.S.T. test is a simple way to remember what to do if you think you or someone else is having a stroke:
   FACE: Check for droopiness on one side
   ARMS: Check for numbness and control
   SPEECH: Check for confused speech
   TIME:     Call 911 immediately

2. Make a note of the time. Effective treatment is extremely time-sensitive:
   Within 4.5 hours of symptom onset, Clot-busting tPA (tissue Plasminogen activator) is effective for Ischemic Stroke (blockage in the artery)
   
   Within 24 hours of symptom onset, surgery can be effective, especially for Hemorrhagic Stroke (rupture of the artery)

3. Perform CPR, if necessary. Most stroke patients don’t require this, especially not with hemorrhagic stroke. But if there is no pulse or breathing, start CPR while waiting for the ambulance.

Here are three things NOT TO DO:

1. DO NOT let the patient go to sleep or talk you out of calling 911.
2. DO NOT give them medication (including aspirin), food, or drinks.
3. DO NOT drive yourself or someone else to the ER. Emergency responders can be delivering treatment on the way to the ER, saving precious time.

Help at home to keep you safe

If you or your loved one needs home care after having a stroke, BAYADA’s compassionate clinicians and caregivers can provide both short- and long-term solutions that provide safe and independent care. That includes nursing, therapy, personal care assistance and much more.

In the meantime, remember that the most important thing to know when faced with a stroke is to act FAST. And that starts with calling 911.