How Can I Tell if I'm Having a Stroke?
by Vicki Rackner MD
What Causes a Stroke?
Although a stroke can be the result of either a blot clot or bleeding, many strokes occur without the cause being identified. When blood carrying oxygen and nutrients required for brain cell survival is denied access to the brain or suddenly bursts and spills around the brain, a stroke can occur. Risk of a stroke is increased when an individual experiences a hardening and narrowing of the arteries, called arteriosclerosis, a condition that can be aggravated by high blood pressure or diabetes.
What are the two types of stroke?
There are two types of strokes: ischemic and hemorrhagic. An ischemic stroke, which stems from a blood clot, occurs when the blood flow to the brain is cut off or interrupted. A hemorrhagic stroke occurs when blood spills into or pools around the brain as a result of a blood vessel bursting.
What is TIA or mini-stroke?
There is also a third type of condition, a transient ischemic attack (TIA), which may have similar symptoms as a stroke, but is not actually a stroke since it does not result in any lasting damage. A TIA is considered a mini-stroke or warning stroke and lasts less than 24 hours. In general, TIAs do not cause permanent brain damage, but are a warning sign of something more severe potentially occurring down the road.
What do stroke symptoms feel like?
A stroke caused by a blood clot or bleeding will produce symptoms within seconds. Below are common symptoms associated with the onset of a stroke:
- One side of the face droops or sags
- Weakness, numbness, and or sudden paralysis particularly on one side of the body or in one part of the body, such as an arm, leg or face
- Difficulty seeing in one or both eyes to include double vision, blurring and dimness
- Slurred speech or sudden difficulty getting words out
- Confusion or difficulty understanding others
- Sudden and severe headache
- Difficulty or inability to swallow
- Sudden disorientation
- Difficulty walking, loss of balance, and dizziness
How can you test for a stroke?
The National Stroke Association suggests remembering the acronym FAST to quickly identify the signs of a stroke:
FACE – Ask the person to smile. Does one side of the face droop?
ARMS – Ask the person to raise both arms. Does one arm drift downward?
SPEECH – Ask the person to repeat a simple sentence (e.g. "It's sunny today."). Are the words slurred? Can the person repeat the sentence correctly?
TIME – If the person shows any symptoms, time is important. Call 9-1-1 immediately.
You can also test for signs of stroke using the "Give Me 5!" keywords from The Stroke Collaborative:
WALK - Is their balance off? Are they dragging or having problems with one side of the body?
TALK - Is speech slurred? Are they having problems talking? Does one side of the mouth droop?
SEE - Are they seeing double? Is their vision blurry?
REACH - Is one side of the body weak or numb? Can they raise both arms over their head?
FEEL - Do they have a severe headache? Is it different from usual headaches?
What should you do if someone is experiencing symptoms of a stroke?
Timing is very important when symptoms of a stroke are apparent. You should immediately call 911 or emergency medical services in order to get an ambulance to the victim as quickly as possible and note the time.
How are strokes treated?
Marking the time stroke symptoms occur is vital. A drug called Tissue Plasminogen Activator (tPA), which is the only FDA-approved medication for stroke treatment, is a clot-busting drug that must be taken within three hours of the onset of stroke symptoms in order to be effective.
A doctor will typically conduct one or a combination of the following types of tests:
- Computed Tomography (CT) Scan, which can identify whether or not bleeding has occurred through a series of X-rays
- Magnetic Resonance Imaging (MRI), which can determine the severity of brain damage, if any, and help predict recovery
- Electrocardiogram (ECG, EKG), which can determine heart problems, such as arrhythmias and atrial fibrillation
- Various blood tests in order to measure blood sugar, blood count, electrolytes, and liver and kidney function
- Carotid Ultrasound/Doppler Scan to analyze and measure blood flow through the artery
- Echocardiogram or Holter Monitoring or Telemetry test to determine whether or not the stroke was caused by a heart condition
If you have reason to believe that you or a loved one may have symptoms of a stroke, call 911 or emergency medical services immediately.
For More Information
1. Knoefel, Janice E. (n.d.) Stroke Awareness & Prevention. Retrieved June 20, 2009, from http://www.americangeriatrics.org/education/forum/stroke.shtml
2. WebMD. (March 6, 2007). Symptoms. Retrieved June 20, 2009, from http://www.webmd.com/stroke/guide/stroke-symptoms
3. National Institute of Neurological Disorders and Stroke. (May 26, 2009). NINDS Stroke Information Page. Retrieved June 20, 2009, from http://www.ninds.nih.gov/disorders/stroke/stroke.htm
4. WebMD. (March 6, 2007). Exams and Tests. Retrieved June 20, 2009, from http://www.webmd.com/stroke/guide/stroke-exams-and-tests
5. American Heart Association. (n.d.) Heart Attack, Stroke and Cardiac Arrest Warning Signs. Retrieved June 20, 2009, from http://www.americanheart.org/presenter.jhtml?identifier=3053
6. American Stroke Association. (March 20, 2009). Learn to Recognize a Stroke. Retrieved June 20, 2009, from http://www.strokeassociation.org/presenter.jhtml?identifier=1020
7. National Stroke Association. (n.d.) What Is TIA? Retrieved June 21, 2009, from http://www.stroke.org/site/PageServer?pagename=TIA
8. National Stroke Association. (n.d). Stroke Symptoms. Retrieved June 20, 2009, from http://www.stroke.org/site/PageServer?pagename=SYMP
9. The Stroke Collaborative (2008). Give Me 5: Stroke Symptoms Retrieved July 28, 2009, from http://www.giveme5forstroke.org/patients/
About Dr. Vicki
Vicki Rackner, MD is a board-certified surgeon and clinical faculty member at the University of Washington School of Medicine. She left the operating room to be on the cutting edge of healthcare consumerism. She is now a full-time patient advocate, helping people get the health care they want, need and deserve. Dr. Vicki is an author, speaker and consultant.