Stroke Symptoms: Weeks Of Warning Signs Or Sudden Attack?

While strokes can occur without warning, there are situations where warning signs may be present for several weeks before a stroke happens. These are known as transient ischemic attacks (TIAs) or mini-strokes, and they are considered medical emergencies that require immediate attention. TIAs are associated with full-blown strokes and other cardiovascular problems that usually occur within days or weeks. During a TIA, the blood supply to the brain is interrupted for a short period, typically from a few minutes to up to 24 hours, and the symptoms are similar to those of a stroke. These include sudden numbness or weakness on one side of the body, confusion, severe headaches, and vision problems. Recognizing these warning signs and seeking prompt medical attention are crucial, as early interventions can effectively prevent a major stroke.

Warning signs of a stroke can occur up to a week before an attack

Another warning sign of an impending stroke is a transient ischemic attack (TIA), also known as a "ministroke". A TIA occurs when the blood supply to the brain is interrupted for a short period. Symptoms of a TIA are similar to those of a stroke and can include:

• Weakness or numbness on one side of the body, usually the face, arm, or leg
• Difficulty speaking or understanding speech
• Loss of vision in one or both eyes
• Dizziness or loss of balance and coordination
• Severe headache

While TIA symptoms usually disappear within an hour and rarely cause permanent damage, it is important to seek immediate medical attention if you suspect you or someone else is experiencing a TIA. Early intervention is critical to reducing the risk of a more severe stroke in the future.

To quickly determine whether someone is having a stroke, the National Stroke Association recommends using the acronym FAST:

• F (Face): Ask the person to smile. Does one side of their face droop?
• A (Arms): Ask the person to raise both arms. Does one arm drift downward?
• S (Speech): Ask the person to repeat a simple phrase. Is their speech slurred or hard to understand?
• T (Time): If you observe any of these signs, call emergency services immediately.

A sentinel headache may precede a stroke

A sentinel headache is a sudden, intense headache that may be a warning sign of a more serious condition, such as a stroke. It is characterised as a headache that is difficult to localise, unlike any previous headache, and not associated with specific activities, foods, or medications. While it is not always the case, a sentinel headache can be an early indicator of a pending stroke.

Sentinel headaches are often intense and severe, and can last for several days or weeks with varying intensity. They are usually a red flag for an impending medical emergency, such as a subarachnoid haemorrhage or a ruptured aneurysm. In some cases, the sentinel headache may be the first sign of a minor bleed in the brain, which could be followed by a larger, more serious bleed in the coming weeks.

Sentinel headaches are often difficult to distinguish from other types of headaches, but they can occur in the days and weeks before a bleed in the brain, which is often called a hemorrhagic stroke. These types of strokes require emergency medical treatment to avoid permanent brain damage or death.

If you experience a sudden, intense headache that is unlike any you have had before, it is important to seek medical care right away to rule out any kind of stroke or neurological emergency.

Warning Signs of a Stroke

It is important to recognise the warning signs of a stroke, as it is a medical emergency that requires immediate treatment. Some of the warning signs include:

• Weakness or numbness of the face, arm, or leg, usually on one side of the body
• Trouble speaking or understanding
• Problems with vision, such as dimness or loss of vision in one or both eyes
• Dizziness or problems with balance or coordination
• Severe headaches with no known cause, especially if they happen suddenly

Transient ischemic attack (TIA) or ministroke is a warning sign

The symptoms of a TIA can include:

• Sudden numbness or weakness on one side of the face, arm, or leg
• Difficulty speaking or understanding speech
• Vision problems in one or both eyes
• Dizziness, loss of balance, or coordination issues
• Severe headache with no apparent cause
• Changes in alertness, such as sleepiness or unconsciousness
• Mental changes, including confusion, memory loss, or difficulty writing or reading
• Muscle weakness or trouble swallowing or walking
• Lack of control over bladder or bowels
• Sensory problems, such as numbness or tingling on one side of the body

It is crucial to recognize these warning signs and seek prompt medical attention. A TIA is a transient event that typically resolves within 24 hours, and early diagnosis and treatment can significantly lower the risk of a future stroke. According to Dr. Feliks Koyfman, a neurologist, there is a 10% chance of experiencing a full-blown stroke within three months after a TIA, with the greatest risk occurring within the first week. Therefore, it is essential to act quickly and determine the underlying cause to prevent future strokes.

To diagnose a TIA, a healthcare provider will perform a complete physical examination, including a neurological evaluation and various tests to rule out a stroke or other disorders. These tests may include imaging scans, such as a CT scan or MRI, angiograms to visualize blood vessels, an echocardiogram to check for blood clots in the heart, and electrocardiogram (ECG) to monitor heart rhythm.

If you or someone you know is experiencing any of the symptoms mentioned above, it is important to act fast and seek immediate medical assistance. Remember, when it comes to stroke care, time lost is brain lost.

The National Stroke Association's acronym FAST can help identify a stroke

Warning signs of a stroke may be evident as early as seven days before an attack. In a 2020 study of 550 adults, a sentinel headache was found to precede an ischemic stroke in 15% of participants. Sentinel headaches are defined as headaches that occur within one week of a stroke.

Transient ischemic attacks (TIAs), or "mini-strokes", are also warning signs of a stroke. They are caused by a temporary interruption of the blood supply to the brain and can last from a few minutes to up to 24 hours. TIAs are often dismissed as their symptoms usually disappear quickly, but they are a medical emergency and a warning that you are at risk of having a stroke.

The National Stroke Association's acronym FAST is a test to quickly identify the three most common signs of a stroke. It can help you determine whether someone is having a stroke and give them the best chance of survival and recovery. Here's what it stands for:

• F = Face Drooping: Ask the person to smile. Does one side of their face droop or is it numb? Is their smile uneven?
• A = Arm Weakness: Ask the person to raise both arms. Is one arm weak or numb? Does one arm drift downward?
• S = Speech Difficulty: Is the person's speech slurred or hard to understand? Can they speak clearly and understand what you're saying?
• T = Time to call 911: If you observe any of these signs, call 911 immediately.

In recent years, the acronym has been updated and slightly modified. It is now BE FAST or FASTER and includes symptoms relating to vision and balance:

• B = Balance: Check if the individual is having difficulty with their balance or coordination.
• E = Eyes: Stroke can affect a person's vision, causing sudden blurred vision, double vision, or loss of vision in one or both eyes, with no pain.

Women can experience more subtle stroke symptoms

Warning signs of a stroke may be evident as early as seven days before an attack, according to a study of stroke patients. These signs require urgent treatment to prevent serious damage to the brain.

While men and women who have strokes often experience a similar set of symptoms, women can also experience more understated symptoms. These can include:

• Fatigue
• Confusion
• General weakness
• Difficulty walking
• Exhaustion
• Brain fog
• Malaise
• Nausea or vomiting

These symptoms are often dismissed and attributed to stress or being overworked. However, it is critical to pay attention to any sudden changes or unusual body functions.

Women are more likely than men to minimize their symptoms and reach out to their primary doctor or drive themselves to the hospital instead of calling emergency services. This can result in delays in receiving time-sensitive, life-saving treatments.

Therefore, it is important for women to be aware of the potential subtle symptoms of a stroke and to seek immediate medical attention if they experience any of these warning signs.

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