The six symptoms and warning signs of a stroke

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The six symptoms and warning signs of a stroke

Every day in the UK around 240 people suffer the catastrophic impact of a stroke. Sometimes seen as “brain attacks” these happen when blood flow to part of the brain is interrupted, cutting off the oxygen and nutrients our brain cells need to survive. 

As brain cells (neurones) can die within minutes, strokes are right up there with heart attacks for being the medical emergencies we most dread. 

They can cause profound life-altering disabilities, such as losing the ability to speak or use certain parts of your body. And sadly, one in four of us will suffer one at some point in our lives.

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There are two main types, ischaemic strokes (accounting for around 87 per cent of all cases) are caused by a blockage (eg a blood clot) in an artery that supplies blood to the brain. 

Haemorrhagic strokes (account for 13 per cent) are when a blood vessel in the brain ruptures, causing bleeding and damage to the surrounding brain tissue. The signs of both are the same.

“Early recognition of a stroke is crucial – it can save lives and prevent long-term disability,” says Dr Branimir Nevajda, a consultant in neurology and stroke medicine at Basildon University Hospital. He explains how the FAST acronym serves as a quick guide to identifying the signs of a stroke and taking action. “Seek immediate medical attention if you notice any symptoms of a stroke, even if they seem to come and go or they disappear completely,” do the following:

Face

Ask the person to smile, can they manage to? Does their face droop on one side? 

Arms 

Ask them to raise both arms. Check if one arm drifts downwards? Or cannot be raised? You can also check legs.

Speech

Ask them to repeat a simple phrase. Do they sound slurred, garbled or incoherent speech, or find speaking difficult?

Time

Act swiftly – if you see any of these signs call emergency services immediately.

This FAST method has remained unchanged for years, though in some regions around the world, this has been expanded to BE-FAST  which includes additional early warning signs related to balance issues and eye problems: 

Balance 

Check for sudden loss of balance or coordination.

Eyes

Check for blurred or loss of vision in one or both eyes.

“During a stroke, the brain is deprived of oxygen, and neurones die at a staggering rate – approximately 1.9 million neurones are lost every minute,” says Dr Nevajda. “This is why acting quickly is so important in stroke treatment. People need to recognise the signs and get help faster. This expansion of the acronym helps identify strokes that may not show the classic “FAST” signs, and thereby increase the chances of getting timely medical intervention.”

Symptoms

Dr Nevajda explains that each stroke symptom, listed below, gives a clue about what’s happening in the brain:

1. Sudden numbness or weakness

This occurs when a stroke disrupts blood flow to areas of the brain that control muscle movement or sensation. As a result, the affected area of the brain can no longer send or receive proper signals to the corresponding body parts.

2. Trouble speaking or understanding speech

Strokes that affect the brain’s language centres, such as Broca’s area (responsible for speech production) or Wernicke’s area (responsible for speech comprehension) disrupt communication pathways, leading to difficulties in speaking clearly or understanding others. This can result in slurred speech or inability to find the right words. 

3. Vision problems

If a stroke occurs anywhere along the visual pathway (i.e. the occipital lobe, the optic nerve, optic pathways or the eye itself) it can cause blurred or double vision or even partial or complete loss of vision in one or both eyes.

4. Severe headache

This is commonly associated with haemorrhagic strokes. It occurs because bleeding in the brain increases the pressure inside the skull.

5. Dizziness or loss of balance

When a stroke affects the posterior regions of the brain (such as the cerebellum or brainstem) that control balance and coordination, it can lead to symptoms of dizziness and vertigo

6. Difficulty walking

Strokes can impair movement in legs, either through weakness or paralysis in the leg muscles themselves (due to damage in the motor cortex) or due to balance problems stemming from affected cerebellar function.

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