Recognize the Signs of a Stroke

Lee Dresser, M.D., remembers an interesting e-mail he got from his dad. It was just a chain letter, but it caught his attention because it listed the warning signs of a stroke.

As a neurologist in Wilmington, Del., who treats stroke patients, Dr. Dresser was glad to see the spotlight on stroke symptoms. "The more people know about the symptoms, the better," he says.

The sooner, the better

The good news about a stroke is that it can be successfully treated. But there's a catch. For the best outcome, a stroke must be diagnosed and treated within about three hours after symptoms begin. Only about 3 to 5 percent of stroke patients arrive at a hospital within three hours after the onset of symptoms.

"That means more than 95 percent of people who are having a [stroke] arrive too late for effective treatment," says Kiwon Lee, M.D., a Philadelphia neurologist. "Unlike 10 years ago, we now have medical and interventional therapies to treat patients. But if you come in a day after you've had a stroke, we can't do much."

Time is brain

A stroke takes place when a blood vessel that carries oxygen and nutrients to the brain is blocked by a clot or bursts. Without blood or oxygen, brain tissue starts to die.

"Most people know that blockage to the heart causes a heart attack that destroys cardiac muscles. But they are unaware that a blockage to the brain causes a [stroke] that destroys brain tissue," Dr. Lee explains.

"A stroke is like a small part of the brain is drowning," adds Dr. Dresser, "and if you don't re-establish blood flow within a very short period of time, part of the brain is irreversibly damaged."

The message is clear: Time is brain. If you notice symptoms of a stroke, call 911 immediately.

Heed the often-painless signs

If time is vital, why do people hesitate to seek help during a stroke? "They often minimize the symptoms and hope they'll disappear," says Dr. Lee. "People call for help when they experience chest pain, and they should do the same for [stroke] symptoms." 

"Most [strokes] are not painful, and pain tends to be the big driver in getting someone to go to an emergency room," says Dr. Dresser. "The natural tendency is to be in denial and just assume that the numbness in your arm is because you 'slept on it funny.'"  

Recognizing the signs of a stroke and treating it as a medical emergency are crucial. Still, prevention is even better. Risk factors including high blood pressure, smoking, heart disease, and diabetes increase the risk for stroke. So do transient ischemic attacks, or TIAs. TIAs are "mini-strokes" with the same symptoms of stroke but which last just minutes.

A stroke can occur at any time, but the risk rises with age. African Americans have a greater risk for death from stroke. That's partly because blacks have higher risks for high blood pressure, diabetes, and obesity.

"High blood pressure is by far the number one modifiable risk factor for [stroke], so if you have hypertension, get it under control," says Dr. Dresser. 

Symptoms of a stroke

In a stroke, every second counts. Know these symptoms and call 911 if you see or have any of them:

• Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body

• Sudden confusion, trouble speaking, or understanding

• Sudden trouble seeing in one or both eyes, or sudden onset of double vision

• Sudden trouble walking, dizziness, or loss of balance or coordination

• Sudden, severe headache with no known cause