A stroke can change your life or the life of a loved one in an instant. But you can reduce the chances for serious disability or death by knowing the signs and taking immediate action.
Every 40 seconds, someone in the U.S. has a stroke. Strokes happen when part of the brain’s blood supply is cut off by a blockage or a burst blood vessel in the brain. “Recognizing the symptoms and acting quickly can be lifesaving, and it can make a meaningful difference in the amount of disability a person experiences afterward,” says Ron Schwartz, M.D., the senior director of continuum services at Masonicare in Wallingford, CT, and assistant clinical professor at the University of Connecticut School of Medicine.
Learn the warning signs you should never ignore, how stroke symptoms can be sneakier in older adults, and why ministrokes are just as big a deal as their full-blown counterparts.
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What Are the Earliest Warning Signs of a Stroke?
Strokes strike quickly, and seeking emergency medical care right away is crucial. But is it possible to predict a stroke ahead of time by looking for certain red flags? In some cases, transient ischemic attacks (TIAs), sometimes called ministrokes, can serve as a potential warning. These episodes have the same symptoms as a stroke, but typically last as little as a few minutes before things go back to normal.
But most people who have a stroke don’t experience a TIA first, according to the American Heart Association (AHA). Rather, the sudden onset of stroke catches most people by surprise. “Most strokes don’t give you a warning that they’re about to happen,” says Ronald Benitez, M.D., a cerebrovascular and neurointerventional specialist with Atlantic Health System in Morristown, NJ.
The best way to head off a potential stroke is by focusing on your risk factors, he adds. These include high blood pressure, high cholesterol, heart disease, diabetes, and being overweight, per the Centers for Disease Control and Prevention (CDC).
And since strokes can’t usually be predicted ahead of time, you should treat any sudden neurological change as an emergency. “Any new problem with speech, vision, strength, sensation, balance or coordination deserves immediate attention,” Dr. Schwartz says.
How to Recognize a Stroke With BE FAST
There’s little time to Google symptoms if you think someone might be having a stroke. “Every minute matters,” Dr. Schwartz says. For that reason, the CDC recommends people memorize the acronym BE FAST, which represents the main symptoms to look for to determine if someone is having a stroke. These tests can help determine if someone is having a stroke:
B - Balance Loss
Have the person stand unassisted. Are they steady on their feet, or are they wobbly or dizzy? Trouble balancing or a new loss of coordination can be warning signs even if they have no other symptoms.
E - Eye (Vision) Changes
Ask the person if they’re having trouble seeing normally. Blurriness, double vision, or not being able to see as well as usual could be signs of a stroke. The change in vision may affect just one eye, especially in older adults.
F - Facial Drooping
Ask the person to smile. If one or both sides of their face droop, they could be having a stroke. Additionally, even if the face is not noticeably drooping, their smile may look uneven, or one side of the face may feel numb.
A - Arm Weakness
Ask the person to raise both arms out to the side. One arm drooping downwards could be a sign of a stroke. They may also describe experiencing sudden weakness or numbness in that arm.
S - Speech Difficulty
Have the person repeat a simple phrase. If they have trouble or their speech is slurred, they could be having a stroke. At the same time, you may note sudden confusion or difficulty understanding what you say.
T - Time to Call 911
Call 911 immediately if a person fails any of these tests. Immediate medical treatment is essential to helping someone survive a stroke. Note when symptoms first appeared, and call for help even if symptoms appear to go away.
Common Stroke Symptoms
Stroke symptoms can be different depending on where in the brain the stroke is occurring, according to the Cleveland Clinic. Some of the more common stroke symptoms include things like:
- Blurry vision or double vision
- Clumsiness
- Confusion or agitation
- Coma
- Dizziness
- Fainting
- Headache that’s sudden or severe
- Memory loss
- Mood swings or sudden personality changes
- Nausea or vomiting
- Neck stiffness
- Seizures
- Slurred speech, trouble speaking, or being unable to speak
- Sudden loss of senses including sight, smell, taste, touch, or hearing
- Weakness or paralysis on one side of the face or body
How Long Can Stroke Symptoms Last?
There are different types of stroke, but in alls cases, a stroke happens when blood isn’t able to flow normally to the brain, either because of a blockage or because of bleeding in the brain. Symptoms typically continue occurring until normal blood flow is brought back, notes the Cleveland Clinic.
That said, the progression of symptoms isn’t the same for everyone. “Symptoms can evolve after a stroke begins. Someone may initially have relatively mild symptoms and then deteriorate. Others may stabilize to some degree and begin recovering,” Dr. Schwartz says.
But in all cases, once a person has had symptoms of a stroke, they need immediate medical attention. “The earlier we evaluate and treat a stroke, the more opportunity we have to limit brain injury and improve outcomes,” Dr. Schwartz adds.
Some people who have a stroke may experience a full recovery after treatment. Others may keep having symptoms or feel the effects of their stroke for months or years, per Johns Hopkins Medicine. For best outcomes after a stroke, follow your stroke rehab plan closely so you can manage symptoms and recover as much of your function as possible.
What Should You Do if You Notice Stroke Symptoms?
If you are worried you or someone else is having symptoms of a stroke, call 911 immediately, urges the National Institute on Aging (NIA). Stroke treatments are time-sensitive, and getting help as quickly as possible can help reduce the risk of permanent brain damage or even death.
When you call 911, the dispatcher will send an ambulance with proper medical equipment to your location, which experts say is better than driving the person to the hospital yourself. “Emergency medical services can begin the evaluation on the way to the hospital and can alert the hospital that a potential stroke patient is coming,” Dr. Schwartz says.
What Does a Ministroke Feel Like?
Ministrokes or transient ischemic attacks (TIA) happen when blood flow to the brain is temporarily blocked. They can cause the same kinds of symptoms as a full-blown stroke (loss of balance, vision changes, muscle weakness, trouble speaking, or confusion) but they may only last a few minutes before symptoms disappear, according to the Mayo Clinic.
“Some people describe it as feeling as though their body suddenly isn’t working right,” Dr. Schwartz says. “The word ‘sudden’ is particularly important. These are generally not symptoms that gradually develop over several weeks. They can appear abruptly and then resolve.”
TIAs don’t cause brain damage, but you should still call 911 right away if a person is having symptoms so they can be evaluated. It’s impossible to tell based on symptoms alone whether a person is having a TIA or a full-blown stroke. Plus, having a TIA is a primary indicator that someone may have a full-blown stroke in the coming days or weeks, the Mayo Clinic notes. So medical attention is essential, even if you or a loved one feels fine.
Can Stroke Symptoms Come and Go?
With a transient ischemic attack, symptoms often disappear within minutes and then return, making it feel like they are making it feel like they are coming and going. While an individual TIA may only last for a few minutes, some people have multiple TIAs within 24 hours, according to the Brain & Spine Foundation.
Do Stroke Symptoms Differ in Older Adults?
Strokes generally cause the same symptoms in people of all ages. But certain symptoms may be more common in older adults, like confusion or one-sided vision loss, found one older analysis published in the Journal of Stroke and Cerebrovascular Diseases. (This was a single study; more research would be needed to determine if it is a consistent pattern.)
More commonly, people might interpret stroke symptoms differently in adults in their 70s, 80s, or beyond. “For example, sudden confusion, dizziness, difficulty walking, or a change in function might initially be blamed on age, medication, fatigue, or another medical problem. That can delay care,” says Dr. Benitez.
The best way to figure out whether a behavior or symptom could be caused by a stroke versus normal aging: Think about how the person typically acts and take action if there’s been a rapid change. “If someone is suddenly speaking differently, walking differently, confused when they normally aren’t, or has a new weakness or vision problem, that sudden change from baseline is what matters,” Dr. Benitez adds.
Takeaways
When you think you or someone you know may be having a stroke, taking fast action can be lifesaving. Remember the symptoms of BE FAST and call 911 for help. Even if you think you can drive to the hospital faster than an ambulance can reach you, medical professionals will have lifesaving equipment aboard the ambulance, which will be far faster than going through hospital admittance. And the faster treatment is started, the better the outcome may be.
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