By Peter Pressman, MD | Reviewed by Claudia Chaves, MD
Don’t ignore these important signs
Stroke is an emergency and requires immediate medical attention. The best treatments available for stroke, such as tissue plasminogen activator (TPA), are most effective the sooner they are given, and after a few hours, they may no longer be useful at all. For this reason, it’s critical that you recognize the symptoms of stroke and go to an emergency room immediately if you suspect you’re having one.
Symptoms of a Stroke
Stroke symptoms begin suddenly, and can include any of the following:
- Difficulty walking:This may be due to lack of balance, weakness, clumsiness, or dizziness.
- Difficulty communicating:You may not understand what other people are saying. You may not be able to form the words you would like to say and lose your ability to write. Your speech may become slurred and difficult to understand.
- Numbness or weakness on one side of the body or face: This may range from total paralysis to a more subtle difference between keeping your left and right arms raised high. Weakness of your face may give one side a drooping appearance.
- Loss of coordination on one side of the body: While your limbs may be strong, you may not have the coordination to do something you could before, such as hold a spoon or button a clasp. In rare cases, a body part may develop abnormal, spontaneous movements.
- Difficulty with vision: This may include seeing double or vision loss in one or both eyes.
- Severe headache: Most strokes do not cause headache, but if the headache has sudden onset, is severe, or is associated with vomiting or decreased consciousness, it may be due to stroke.
- Seizure: Most of the time, seizures are not due to stroke. On the other hand, strokes are the most common cause of new seizures in someone over the age of 50 who has no history of prior seizures.
How Long Symptoms Last
Symptom duration depends on the size and severity of the stroke. Symptoms may last less than an hour, but they can also remain for a lifetime. Even if the physical damage left by a stroke doesn’t resolve with treatment, sometimes the brain can “rewire” itself to find new pathways for information to travel in order to regain function. The longer a symptom lasts, the more likely it is that it will remain permanent. It’s usually best to address problems caused by a stroke as soon as possible.
What to Do If the Symptoms Go Away
Even if your symptoms go away, an evaluation as soon as possible is still warranted. Transient ischemic attacks (TIAs) are a type of stroke caused by a temporary loss of blood flow to part of the brain. For example, a clot may have lodged in an artery and blocked blood flow, but has now broken up and passed through. Although blood flow may have restored itself, you are at an increased risk of having another episode with permanent symptoms.
What to Do If You Think You’re Having a Stroke
Dial 911. If you’re unable to speak clearly, get someone to help you. The sooner you get to the emergency room, the better the chances that your stroke will not have long-term consequences.
Aspirin and Other Medication
Don’t worry about taking aspirin or other medication. It’s more important to get to an emergency room right away. About 85 percent of strokes are ischemic, meaning that a clot has stopped blood from moving to parts of the brain. These strokes are helped by medications like aspirin. However, 15 percent of strokes are caused by bleeding into the brain, in which case aspirin makes things worse. It’s best to be evaluated to know what type of stroke you might be having before taking any medicine.
What Happens in the Emergency Room
When you arrive at the emergency room, doctors will want to quickly decide if you are likely having a stroke and if it’s safe to give you a blood thinner like TPA.
They may ask the following questions to help guide their decision-making:
- When were you last feeling normal? Did you wake up with these symptoms, or do you remember the exact time they started?
- What is your medical history? Do you have stroke risk factors such as diabetesor smoking? Have you ever had a stroke before?
- Do you have a bleeding or clotting disorder?
- Have you had bleeding in your brain before? Have you had recent surgery or physical trauma?
- What medications do you take?
- Do you have metal anywhere in your body, such as surgical clips or hardware? Are you claustrophobic? These questions are important to determine the safety of an MRI.
Remember, stroke is an emergency, and every minute counts. It’s best if you are seen in the emergency room within an hour of your first symptoms. If you have any doubts about whether you might be having a stroke, you need to speak with a medical professional right away.
- Mayo Clinic Staff. Stroke. Mayo Clinic. Updated November 11, 2017.
- Ropper AH, Samuels MA, Klein JP. Adams and Victor’s Principles of Neurology.10th ed. McGraw-Hill Education; 2014.