Stroke Symptoms and Warning Signs

FAST is an acronym to help you quickly recognize the warning signs and symptoms of stroke.

A stroke occurs when the blood supply to an area of the brain is cut off. The symptoms depend upon the region of the brain that is affected by the loss of blood supply and can include changes in sensation or motor control.

Symptoms of a stroke also depend on how much of the brain tissue is deprived of blood supply and for how long. For example, someone who had a mild stroke may experience symptoms such as temporary weakness of an arm or leg, but those with a more severe stroke may be permanently paralyzed on one side of their body or be unable to speak. If the blood supply is not quickly restored, either on its own or via medical treatment, the effects may be permanent.

A transient ischemic attack, or TIA, is sometimes referred to as a "mini-stroke." With a TIA, the stroke symptoms occur but go away on their own.

Some people fully recover from strokes, but over two-thirds of stroke survivors are left with some type of disability. People who experience mild stroke symptoms often show improvement in the first three to six months.

Acting fast is critical if you suspect that someone may be having a stroke. Immediate treatment of a stroke can minimize the long-term effects of the stroke and can even help reduce a person's risk of death from stroke.

An effective approach to recognizing and responding to a stroke is "FAST." FAST is an acronym that stands for face drooping, arm weakness, speech difficulties, and time to call emergency services.

The FAST stroke approach serves as a critical tool that can help you quickly recognize the warning signs and symptoms of a stroke. You can even download the FAST app from the webpage of the American Stroke Association to help you remember these signs.

Use FAST to remember and recognize the following signs and symptoms of stroke:

• F: Face drooping. Ask the person to smile, and see if one side is drooping. One side of the face may also be numb, and the smile may appear uneven.
• A: Arm weakness. Ask the person to raise both arms. Is there weakness or numbness on one side? One arm drifting downward is a sign of one-sided arm weakness.
• S: Speech difficulty. People having a stroke may slur their speech or have trouble speaking at all. Speech may be incomprehensible. Ask the person to repeat a simple sentence and look for any speech abnormality.
• T: Time to call 911! If a person shows any of the symptoms above, even if the symptoms went away, call 911 and get the person to a hospital immediately.

Using FAST, stroke can be identified early, which may help prevent further complications.

While these are the hallmark symptoms of stroke, a stroke can cause disruption of any function of the nervous system. Symptoms of stroke typically occur on one side of the body and come on suddenly. Some people may experience mild stroke symptoms, whereas others may experience severe symptoms. With a transient ischemic attack (sometimes called a mini-stroke or TIA), the symptoms appear and may go away on their own. In any case, it is essential to get the affected person to a hospital as soon as possible to enable prompt treatment.

Other possible signs and symptoms of stroke include the sudden onset of:

1. Weakness or paralysis of any part of the body
2. Numbness or a "pins and needles" sensation anywhere in the body
3. Gait disturbances (trouble walking) or loss of balance and coordination
4. Vision changes, blurred vision, or trouble with eyesight in one or both eyes
5. Dizziness
6. Severe headache that usually is unlike headaches in the past
7. Confusion
8. Inability to speak, slurred speech, or inability to understand speech
9. Loss of sensation in any part of the body
10. Memory loss
11. Behavioral changes
12. Muscle stiffness
13. Difficulty swallowing
14. Involuntary eye movements

The symptoms of a TIA or mini-stroke are the same as those of a stroke as listed above. With a mini-stroke, the symptoms go away on their own. Any symptoms of a stroke, including severe or mild stroke symptoms, can occur during a mini-stroke. There's no way to tell how long the TIA (mini-stroke) symptoms will last, and every minute is crucial. Never underestimate TIA symptoms, as they serve as a warning that a stroke may occur. Nearly 20% of individuals who experience TIA symptoms may have a mild or severe stroke within 90 days.

Remember to think and act FAST (Face drooping; Arm weakness; Speech difficulty; and Time to call 911!) if you see someone who may be having these symptoms. Don't delay and call 9-1-1 immediately. You may help save a life or reduce the chance of long-term disability.

A person who is having a stroke is typically cared for in an emergency department, and initially seen by a specialist in emergency medicine. Doctors typically involved in the care of patients with stroke can include

• neurologists,
• endovascular surgical neuroradiology (ESNR) specialists,
• interventional radiologists (IR),
• interventional cardiologists (IC), and
• critical care specialists.

• What are the early symptoms of a mild stroke? The early warning signs of a mild stroke include weakness or numbness of the face, arm, or leg, typically on one side of the body. You may also experience slurred speech or trouble understanding others. Mild stroke symptoms vary among individuals but often occur suddenly.
• How can you tell if someone is having a mild stroke? When someone is having a mild stroke, they may show signs such as face drooping, arm weakness, and slurred speech.
• Can a stroke go unnoticed? Yes, a stroke can sometimes go unnoticed, particularly if there are no noticeable symptoms. It is referred to as a silent stroke.
• What is the difference between a mild stroke and a TIA? The primary difference is that a TIA involves a temporary obstruction of blood flow that does not cause permanent damage, whereas a mild stroke (also referred to as a minor stroke) results in permanent damage.
• How long do stroke symptoms last? The symptoms of a stroke can last anywhere from a few minutes to several days.
• What should you do if you suspect a stroke? If you suspect a stroke, call 911 immediately and inform the dispatcher that it is a stroke. While waiting for help, note the time of symptom onset, loosen any restrictive clothing, have the person lie down, check for pulse and breathing, and stay calm. Remain by the person's side until paramedics arrive.
• Can you recover fully from a stroke? Yes, a full recovery is possible after a stroke, but it depends on several factors including the severity of the stroke, the promptness of treatment, and the type and intensity of rehabilitation.
• What tests are used to diagnose a mild stroke? Some of the tests commonly used to diagnose a mild stroke include a brain CT scan, MRI, and angiography.