Strokes occur when a blood vessel in the brain ruptures and bleeds, or when there’s a blockage in the blood supply to the brain. This prevents blood and oxygen from reaching the brain’s tissues. The brain cells in the immediate area slowly begin to die.
It is the fourth leading cause of death in the United States. An estimated 795,000 people experience strokes yearly. It is also the leading cause of long-term disability in people.
Strokes are typically sudden attacks but they can also occur over hours or several small strokes can happen over time. The symptoms may build in intensity as the stroke becomes more acute.
The F.A.S.T. test was created in 1998 to help emergency personnel, doctors or even those with little medical training, to quickly assess stroke victims.
- F (face) – One side of the face droop or becomes numb. To check, ask the person to smile. Notice if the person’s smile is uneven or lopsided.
- A (arms) — One arm becomes weak or numb. Ask the person to raise both arms. Take note if one arm drifts downward.
- S (speech) — Slurring words and poor understanding of simple sentences. Ask the person to repeat a simple sentence.
- T (time) — If the person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital immediately. The longer the brain is denied of its blood supply, the greater the brain damage possible.
Signs and Symptoms:
Men and women share a common set of stroke symptoms but women may experience more subtle symptoms.
Any of these symptoms can occur in a mild, brief way but if any of these symptoms come on suddenly and is quite severe, it could signal the onset of a stroke.
1. Sudden paralysis or numbness in one side of the body (face, arm or leg)
Paralysis is the loss or impairment of voluntary muscular power. Often this is not due to problems with the muscles themselves. It is due to a problem that occurred somewhere in the connection of nerve cells that run between the body parts to the brain and back again.
This sudden loss of strength or sudden onset of numbness on one side of the body is an important warning sign that a stroke may occur.
The numbness occurs because one half of the brain controls the opposite side of the body. Any irregularities that may happen on that part would affect the side of the body that it has control over.
One side of the face may start to droop. It is another tell-tale stroke sign. The corner of an eye or mouth may drop because of the affected side of the brain’s difficulty in controlling muscle. The nerves that control the muscles are damaged.
2. Sudden confusion
Sudden confusion, or delirium, is a symptom that should not be taken lightly.
Delirium is a neurological condition where a person may experience serious disturbances in mental abilities. A person becomes unable to think with his or her usual level of clarity. Frequently, confusion leads to the loss of ability to recognize people or places or tell time and the date.
It also results in, disorientation, hallucination, struggle in focusing and difficulties remembering details.
Sudden confusion is a sign that something broke off within the brain and caused a decreased blood flow to the brain.
If the confusion has come on suddenly, it requires immediate medical attention especially if the patient is showing other signs linked to stroke.
3. Slurred speech or difficulty in understanding speech
Difficulty in speaking, along with sudden numbness and weakness in one arm, is one of the three main signs of a stroke.
Aphasia and dysarthria are two medical terms that are used in line with this symptom.
To differentiate them, aphasia is referred to as a communication disorder that hinders a person’s ability to use and understand words. It, however, does not impair a person’s intelligence.
Dysarthria, on the other hand, is a condition in which muscles used for speech become weakened or damaged. It is often is characterized by slurred or slow speech that can be difficult to understand.
When the oxygen supply has been cut off from the brain by a blood clot, areas of the brain (usually in the left side of the brain) that control speech and language get damaged.
4. Sudden trouble seeing in one or both eyes
Vision relies on two factors: having a healthy eye to receive visual information and a healthy visual processing center in the brain that interprets and processes the information.
The apparent loss of vision in one eye can be a sign of an impending stroke.
Hemianopia is a state where there is a loss of one half of the visual field. This may mean that there is an inability to see either the left or right from the center of the field of vision in both eyes.
If a stroke has affected one side of the brain, a field loss to the opposite side may develop. The extent of field loss can vary and depends on the area of the brain that has been affected by the stroke.
5. Sudden trouble walking, loss of balance or coordination
Balance involves coordination and stability. It is very complex and involves many different parts of the body such as the ears, eyes, and sensory nerves in the muscles and joints.
To have good balance, different parts of the body, like the brain, eyes, and limbs, need to work well together. A stroke affects this balance system and the way in which the parts work together.
Usually, the body can overcome mild problems, but if they are more severe, the system will be unable to work effectively and the body will probably become unsteady.
Disruption in this system can still make it possible to walk but there might be a difficulty with lifting the toes quickly enough to stop them catching on the ground with each step. This is known as foot drop, and it can make anyone feel unsteady or more likely to trip. Or you may find that you have less energy so that you tire easily and then become unsteady.
Another factor affecting balance is the loss of sensation on the affected side, particularly the legs. If a person cannot feel where their legs and feet are, especially when the feet are safely on the ground, it is very difficult to know how to move. All of this increases your risk of having slips, trips, and falls.
Dizziness is a very common medical complaint. It can be caused by a number of health problems.
In a small percentage of people, dizziness can be a sign of something more serious. Dizziness could signal that a stroke is occurring.
A stroke usually begins abruptly. It reduces the blood supply to the back part of the brain and causes dizziness.
Strokes disrupt the connection between the brain and the cerebellum. The cerebellum controls the coordination of the face and body. If the cerebellar function is hindered, a physical imbalance would result.
In addition, strokes may also interfere with the balance of eye movement. If this is the case, double vision or jerky movements may contribute to the dizziness.
7. A severe and unexplained headache
Headaches are very common symptoms of other health conditions.
A sudden headache that appears out of the blue and reaches peak severity in seconds is a symptom of stroke.
Strokes occur when blood flow to the brain is blocked.
The central point of a stroke headache may depend on where the stroke is occurring. It can also be associated with a loss of sensation of feeling or vision
People often describe a stroke headache as being the worst headache they have ever experienced. It also appeared without warning.
The pain generally won’t be throbbing or develop gradually like a migraine. Rather, it will hit hard and fast.
A subarachnoid hemorrhage is one type of bleeding stroke. It is generally caused by the rupture of a weakened bulge (an aneurysm) in a blood vessel at the base of the brain. The bleeding then triggers a very intense headache.
Painful hiccups may be an early sign of a stroke.
Hiccup is a respiratory reflex action. It is also medically known as synchronous diaphragmatic flutter or singultus (SDF). Hiccups occur following the sudden contraction of the diaphragmatic and intercostals muscles with the closure of the glottis.
They can occur individually or in bouts and are often rhythmic.
When a person is suffering a stroke, the hiccups may come out of nowhere. The pain may become too much that the person would ask to be taken to an emergency room.
A stroke-related hiccup might also include chest pain, all-over numbness, or a bit of blurred vision.
Strokes also affect the brain’s breathing center, it can trigger a sudden, protracted case of hiccups, more commonly in women.
9. Nausea and vomiting
Nausea and vomiting are both nonspecific symptoms. This means that they can be linked to a long list of possible causes.
However, a sudden onset of both might mean a serious underlying medical problem.
If a stroke is taking place in the cerebellum, it can cause nausea and vomiting.
Many different parts of the brain contribute to the sense of balance and equilibrium. The cerebellum specifically plays a major role in movement and balance. If the body’s sense of balance is thrown off so much that it causes a person to vomit. It’s almost like having motion sickness without being in motion.
When the body’s balance is thrown off due to stroke, a person might feel nauseous and start vomiting. Or might not feel nauseous at all and still vomit anyway.
Women are more at risk for this symptom.
10. Memory loss
Memory loss commonly occurs as a result of the loss of nerve cells in the brain.
A transient ischemic attack (TIA) is a brief episode during which parts of the brain do not receive enough blood. There is no permanent brain tissue damage because the blood supply is restored quickly. These attacks are often early warning signs of a stroke, however.
Memory loss due to a transient ischemic attack are often temporary and vary depending on the area of the brain affected.
Short-term memory loss is the most common form of memory loss due to a TIA. Patients experiencing short-term memory loss will have vivid memories from long ago but will have difficulty remembering the events of the present day.
This is a subtle symptom and women are the most commonly affected by it.
11. Fatigue and general weakness
Everyone feels tired sometimes. It is a normal part of life and can happen for all sorts of reasons, such as if you haven’t slept well or have had a very busy day. Fatigue does not always improve with rest and is not necessarily related to recent activity.
Women are most likely to experience fatigue related to stroke.
In part, experts say, women may have symptoms subtle enough to be missed or brushed off in the daily juggle of work-life balance. That can lead to delays in getting time-sensitive, life-saving treatments.
Women frequently have atypical, vague symptoms. They might start with fatigue, confusion or maybe general weakness, as opposed to weakness on one side of the body.
12. Muscle stiffness
Normally, the muscles and brain are in constant communication. The muscles tell the brain how much tension they’re under, and the brain tells the muscles how and when to move.
When a stroke damages the motor neurons in the brain, it impairs the brain’s ability to tell muscles how and when to move.
As a result, the muscles try to protect themselves by tensing up. This results in muscle stiffness after stroke. It is formally known as spasticity.
Some patients may lose control of muscles altogether. Spasticity in the leg muscles can make it difficult to walk. This can lead to problems with movement and balance.
Always take note of what time the stroke victim began showing symptoms and call 9-1-1 immediately.
It takes only a few seconds for the brain to stop functioning when a stroke causes a brain hemorrhage. Knowing the warning signs of a stroke may be the difference between recovery and disability.