Stroke Warning Signs: How to Recognize Them, When to Call 911 and How to Lower Your Risk

What it involves

MedlinePlus explains that a stroke happens when blood flow to part of the brain is lost, so brain cells cannot get the oxygen and nutrients they need and start to die within minutes. About 80 percent of strokes are ischemic, caused by a clot that blocks a blood vessel, and the rest are hemorrhagic, caused by a vessel that bleeds into the brain.

Who this is for

• Adults with high blood pressure, diabetes, high cholesterol or an irregular heartbeat
• Patients who have had a mini-stroke or a stroke and need follow-up care
• Smokers and former smokers who want to lower their risk
• Family members who want to know the signs before they are needed

What to expect

• A review of your blood pressure, blood sugar, cholesterol and heart rhythm, the main risks MedlinePlus lists
• Blood work and, at the Loxahatchee and West Palm Beach offices, an EKG when your provider thinks it is useful
• A plan for medicines, food, activity and quitting smoking that fits your health
• A referral for brain imaging, a carotid ultrasound or a neurologist when your history calls for it

The signs to know: F.A.S.T.

MedlinePlus lists sudden numbness or weakness of the face, arm or leg, especially on one side; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden difficulty walking, dizziness or loss of balance; and a sudden severe headache with no known cause. The F.A.S.T. test condenses it: Face drooping on one side when smiling, Arm drifting downward when both are raised, Speech that is slurred or strange, and Time to call 911. Every minute counts during a stroke. Sudden loss of vision in one eye or double vision, especially with a new headache and tender temples in someone over 50, can also be a warning sign of giant cell arteritis, which the giant cell arteritis guide explains.

Why you call 911 and not the office

The encyclopedia calls a stroke a medical emergency and says to call 911 or the local emergency number at the first signs. If a clot caused it, a clot-busting medicine may be given, but it must be started within four and a half hours of when the symptoms first began, and the sooner the better. That treatment is given in a hospital, which is why no office visit should stand in for 911. Symptoms such as sudden dizziness, a sudden headache or trouble walking are covered in the dizziness guide for the non-emergency versions. Heart attack symptoms in women can look different from the classic picture, and the guide to heart attack warning signs in women explains why the call to 911 applies there too.

The mini-stroke that passes

MedlinePlus describes a transient ischemic attack, or TIA, as blood flow to the brain being blocked for a short time. The damage to brain cells is not permanent, but having a TIA puts a person at much higher risk of a stroke. The encyclopedia notes that symptoms can come and go over the first day or two, so a sign that fades is not a reason to wait. After any such episode, an exam of blood pressure, heart rhythm and blood sugar is part of finding the cause. Narrowing of the neck arteries is one source of these warnings, explained in the carotid artery disease guide.

Risks a routine visit can work on

MedlinePlus names high blood pressure as the primary risk factor, followed by diabetes, heart disease such as atrial fibrillation, smoking, a personal or family history of stroke or TIA, and age. African American and Hispanic people have a higher risk. High cholesterol, obesity, alcohol and drug use, an unhealthy diet and too little activity also raise it. The guides on blood pressure readings, atrial fibrillation and the cholesterol panel explain the numbers a provider checks.

Lowering the risk

The health topic page advises heart-healthy habits: eating a heart-healthy diet, aiming for a healthy weight, managing stress, getting regular physical activity, quitting smoking, and managing blood pressure and cholesterol, with medicine added if lifestyle changes are not enough. The practice lists blood pressure care and diabetes management among its services, and the quitting smoking guide explains where to start with the habit that damages blood vessels.

After a stroke

MedlinePlus says recovery begins in the hospital or a rehab center and continues at home, and that problems with moving, thinking and talking often start to improve in the days to weeks afterward. Many people develop depression after a stroke, which it describes as very treatable, and the depression screening guide explains the questions a provider asks. The risk of a second stroke is highest in the weeks or months after the first. The encyclopedia says to be sure to follow up with your provider after you go home.

Sources

• MedlinePlus: Stroke (health topic)
• MedlinePlus: Stroke (medical encyclopedia)