Recognizing Minor Stroke Symptoms: Webmd's Guide

Strokes are a serious medical condition that can lead to permanent brain damage or death if not treated quickly. They occur when blood flow to an area in the brain is cut off, resulting in the death of brain cells due to oxygen and glucose deprivation. Recognizing the symptoms of a stroke is crucial for prompt treatment and can save a person's life. The FAST acronym is a widely recognized tool for identifying the most common signs of a stroke, which include face drooping, arm weakness, speech difficulties, and time to call emergency services. In addition, other warning signs such as balance issues, vision problems, severe headaches, and confusion should not be ignored as they could indicate a stroke or a mini-stroke, known as a transient ischemic attack (TIA). Being aware of these symptoms and acting quickly can make a significant difference in the outcome of a stroke.

Face drooping

A stroke can cause facial drooping, also known as facial palsy, on one or both sides of the face. The eyelids, cheeks, or corners of the mouth may droop, and the person may have an involuntary smile or be unable to smile intentionally. The drooping may also cause difficulty speaking.

Facial drooping is a common symptom of a stroke and can be identified using the F.A.S.T. acronym:

• F = Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
• A = Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
• S = Speech Difficulty – Is the person's speech slurred or garbled?
• T = Time to call 911 – Stroke is an emergency. Every minute counts. Call 911 immediately and note the time when the symptoms first appeared.

If you suspect that you or someone else is having a stroke, it is important to act quickly. Call emergency services right away and follow the instructions of the emergency responder. Do not attempt to drive to the hospital yourself, as this will waste valuable time.

Facial drooping does not always occur during a stroke, and its absence does not mean that a person is not having one. If other stroke symptoms are present, such as arm weakness, speech difficulty, blurred vision, or sudden dizziness, seek emergency medical care immediately.

Arm weakness

The American Stroke Association uses the acronym F.A.S.T. to help people recognise the signs of a stroke. The 'A' stands for Arm weakness. If someone is experiencing a stroke, they may have weakness or numbness in one arm. If they try to raise both arms, one arm may drift downward. This is a sign of one-sided weakness.

If someone is experiencing arm weakness, ask them to raise both arms. If one arm is weak or numb and drifts downward, this could be a sign of stroke. Call 911 immediately.

After a stroke, some people are left with problems in one of their arms. Arm care is important to prevent and treat these issues. This includes techniques such as proper positioning, using devices like a sling or brace, and preventing further injury.

Speech difficulty

Aphasia can affect a person's ability to translate their thoughts into coherent speech, and they may not understand what is being said to them. Their speech may be jumbled, fragmented, or hard to understand. It can also affect a person's ability to read and write.

Dysarthria is a similar condition, where a person cannot control the muscles in their face, mouth, and throat, making it difficult to speak clearly. Their speech may become slurred or slow, and their voice may sound quiet.

Apraxia of speech is another condition where a person cannot move the muscles in their face, mouth, or throat in the correct order when speaking, making it difficult for others to understand them.

Speech and language therapy can help improve a person's speech, reading, and writing abilities after a stroke.

Time to call 911

The acronym F.A.S.T. is a useful tool to help you recognise the signs of a stroke and know when to call 911.

F = Face Drooping

Does one side of the person's face look like it's drooping? Is it numb? Ask them to smile. Is their smile uneven?

A = Arm Weakness

Is one of their arms weak or numb? Ask them to raise both arms. Does one arm drift or drop downwards?

S = Speech Difficulty

If you notice any of these signs, it's T = Time to call 911. Check the time so you know when the first symptoms appeared. Call 911 even if the symptoms go away.

Other warning signs of a stroke include:

• Numbness or weakness of the face, arm, or leg, especially on one side of the body
• Confusion, trouble speaking or understanding speech
• Vision trouble in one or both eyes
• Trouble walking, dizziness, loss of balance or coordination
• Severe headache with no known cause
• Memory loss
• Passing out or fainting

Vision trouble

• Visual field loss or a field cut: This is a blind spot in the person's normal visual space, often affecting both eyes. Reading can become difficult, and therapy may involve using line guides or devices to help isolate lines of text.
• Visual spatial inattention or neglect: This can result in the person not paying attention to the side of their body affected by the stroke. For example, they may ignore food on the left side of their plate or neglect to shave one side of their face. Rehabilitation involves learning to scan from side to side and judging space by touching things at different distances.
• Double vision (diplopia): Double vision can cause a loss of depth perception. An eye patch can help reduce the information the brain has to process, but it doesn't fix the underlying issue.
• Oculomotor dysfunction: This occurs when the eyes cannot track or move smoothly between objects, often causing reading and walking difficulties.
• Visual midline shift: This can cause a person to perceive the floor and walls as tilted, and they may tilt their body to compensate. Treatment involves balance activities and the use of special prism glasses called yoked prisms.
• Eye movement disorders: These can include rhythmic eye movements (nystagmus), misaligned eyes (strabismus), eye tracking control issues (oculomotor dysfunction), and double vision (diplopia). Depth perception, balance, coordination, and overall vision may be affected.
• Dry eyes: Some stroke survivors have trouble blinking or fully closing their eyes, leading to irritation, burning, or blurry vision.
• Poor visual memory: Stroke survivors may experience difficulty remembering what they have seen.
• Decreased depth perception: This can affect the ability to judge distances and locate objects.
• Reading problems: Stroke survivors may find reading challenging due to visual field loss, oculomotor dysfunction, or other vision issues.
• Visual hallucinations (Charles Bonnet syndrome): These can occur when the brain generates images in the area of vision loss. The images may be simple patterns or more complex scenes involving people and places.

Vision rehabilitation, including therapy and the use of optical aids, can help stroke survivors manage their vision problems and improve their daily functioning. Eye doctors (ophthalmologists and optometrists) and brain-eye doctor specialists (neuro-ophthalmologists and neuro-optometrists) can diagnose vision issues and develop treatment plans to help improve visual function and independence.

Frequently asked questions