Here's a fun topic to talk about on a sunny afternoon: how to identify stroke warning signs. Almost 800,000 Americans will have a stroke this year and over three quarters of these will be new or first time events. Strokes are a leading cause of long term disability in America and the fourth leading cause of death. When you're facing a situation in which delayed treatment literally means loss of brain cells, it's good to be informed.

Patients treated soon after the onset of symptoms are more likely to survive and less likely to suffer disabilities after 3 months. Awareness of the warning signs and symptoms is the best way to ensure that patients get the prompt care they need. So let's get started shall we?


What is a stroke?

The majority of strokes are a result of something blocking blood flow to the brain. In other cases, stroke may be caused by hemorrhage.

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Regardless of the cause, it's not surprising that early action is critical. When blood and oxygen are kept from the brain, cells begin to die, resulting in permanent damage.


How do I identify a stroke?

Let me start by saying that not all strokes show symptoms. That said, below are some of the common symptoms to look out for and signs that you should be rushing to the hospital or calling 911 immediately.

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You have to act FAST when you see these signs which is convenient because that's the acronym we use to remember them! This is cribbed from the American Stroke Association. Ready?

F: FACE DROOP: Does one side of the face droop or is it numb? Ask the person to smile Is the person's smile uneven?

A: ARM WEAKNESS: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S: SPEECH DIFFICULTY: Is speech slurred? Is the person unable to speak or hard to understand. Ask the person to repeat a simple sentence, like "the sky is blue." Is the sentence repeated correctly? I would add to this section problems with texting. In the past few years there have been cases indicating that disjointed and nonsensical texting may be indicative of a stroke in much the same way as speech difficulty is.

T: TIME TO CALL 911 (or your equivalent): If someone shows any of these symptoms, even if the symptoms go away,* get the person to the hospital immediately. Receiving emergency treatment within 3 hours of symptoms can be a critical factor in survival. Note the time that symptoms began as this can effect treatment.


Strokes can be terrifying and are dangerous but there ARE treatment options available. If you see these signs or symptoms in yourself or others, get yourself to the hospital immediately. See one sign and not others? Hospital. Suspect but not sure? Hospital. Early treatment leads to better outcomes which means less time lost at work, less spent on therapy, and potentially a longer life.

Don't dawdle. Time is brain - the clock is ticking.

note: I can go into significantly more detail about stroke and risk factors but wanted to keep it simple for now. I'd be happy to answer any questions in the comments.

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ETA: The Time is Tissue in general. This goes for heart muscle, skeletal muscle, and brain. If blood flow is obstructed to tissue, the faster you get it fixed, the more likely you will be to make a full recovery!


*Transient Ischemic Attacks (TIAs) are "mini-strokes" in which the symptoms go away within 24 hours – generally symptoms will resolve in 1-2 hours. These patients still require medical evaluation!

(images from webmd and the American Stroke Association)