Stroke Warning: 4 Signs You Need To Know

Strokes are a medical emergency and can happen when the blood supply to the brain is interrupted or blocked. It is important to be able to spot the signs of an impending stroke as this can make a big difference in recovery. The National Stroke Association has developed the acronym FAST to help identify the signs of a stroke:

- F (Face): One side of the face droops or is numb.

- A (Arms): One arm is weak or numb and may drift downward.

- S (Speech): Speech is slurred or hard to understand.

- T (Time): If any of the above signs are observed, call 911 immediately.

Face drooping or weakness

A stroke occurs when the blood supply to the brain is cut off, causing brain cells to become damaged and die. This can be due to a blockage from a blood clot or bleeding from a blood vessel in the brain. During a stroke, the face may droop on one or both sides. This is often called facial palsy.

The lower part of the face is usually affected, with the eyelids, cheeks, or corners of the mouth drooping. The brow and upper eyelid typically remain functional, but the lower eyelid may be pulled down due to loss of muscle tone and strength in the cheek. The face may also appear to be involuntarily smiling, while a voluntary smile may be difficult to achieve.

The person may experience difficulty in speaking, eating, and drinking. They may also have trouble understanding speech. These symptoms are due to muscle weakness or paralysis affecting the eyes, lips, and mouth on one or both sides of the face.

To identify face drooping, ask the person to smile and check if their smile is uneven. This is a critical step in the FAST test, which is used to identify the signs of a stroke.

Arm weakness or numbness

If you suspect that you or someone else is having a stroke, it is important to act F.A.S.T. (Face, Arms, Speech, Time). Ask the person to raise both arms. If the arm with suspected numbness or weakness drifts or drops downward, this could be a sign of an impending stroke. This is a sign of one-sided weakness.

If you observe this sign, it is important to call emergency services immediately. Do not drive to the hospital or let someone else drive you. Ambulance workers can begin life-saving treatment on the way to the hospital, and minutes matter in treating strokes.

In addition to arm weakness or numbness, other stroke symptoms include:

• Face drooping: Ask the person to smile. Does one side of their face droop or feel numb?
• Speech difficulty: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
• Time to call emergency services: If you observe any of the above signs, call emergency services right away. Note the time when any symptoms first appear, as this information helps healthcare providers determine the best treatment.

Speech difficulties

Broca’s Aphasia (Expressive Aphasia)

Characterized by difficulties in spoken and written expression. Individuals may have trouble producing speech and understanding language, although they possess the physical ability to speak.

Anomic Aphasia

Individuals with this type of aphasia experience difficulty with word retrieval and may exhibit slow or halting speech.

Wernicke’s Aphasia (Receptive Aphasia or Fluent Aphasia)

This type of aphasia leads to challenges in understanding speech and producing meaningful language. While individuals with Wernicke’s aphasia can speak long and fluent sentences, the words they use may not make sense.

Conduction Aphasia

People with conduction aphasia have trouble repeating words or phrases and often make speech errors.

Global Aphasia

Global aphasia severely impairs both speech production and comprehension abilities.

If you or someone you know is experiencing speech difficulties, it is important to seek medical attention immediately. Speech and language therapy can help improve speech, reading, and writing abilities and teach alternative communication methods.

Vision problems

There are four main types of vision problems that can occur after a stroke:

Visual field loss

This is where you have missing areas of your vision, often affecting the same side of the visual field in both eyes. Hemianopia is the most common type, where you lose the left or right half of the visual field in both eyes. Scotoma is less common, causing a small patch of vision loss, often near the centre. Visual field loss can make tasks like reading very difficult, and can also cause issues with getting around, particularly in crowded or unfamiliar places.

Eye movement problems

Damage to the nerves that control the muscles that move your eyes can lead to a variety of eye movement problems. These can include impaired eye movements, making it difficult to move your eyes between objects or to follow a moving object. You may also experience a constant wobbling of the eyes, known as nystagmus, which can cause double vision and make it hard to focus on objects.

Visual processing problems

Visual processing problems occur when the brain has difficulty processing information received from the eyes and other senses. This can manifest in several ways, such as difficulty recognising objects, people, colours, or text. It can also cause issues with reaching for objects and seeing more than one object at a time.

Other sight problems

Other issues that can affect your vision after a stroke include light sensitivity, dry eye, and visual hallucinations (Charles Bonnet syndrome). Light sensitivity can cause discomfort in bright light or glare, and can be eased with tinted glasses or eye shields. Dry eye can be treated with artificial tear eyedrops and ointments. Visual hallucinations are not a symptom of mental health issues but are caused by the brain generating images in the missing area of vision. They often improve over time as the brain adjusts to the loss of vision.

Dizziness or balance issues

Dizziness and balance issues can be a sign of stroke, but they are not always caused by strokes. Dizziness is more commonly caused by low blood pressure or low blood sugar, or by inner ear conditions. However, if you are experiencing dizziness or balance issues, it is important to get medical attention, as it may be a sign of something more serious.

A stroke occurs when the blood supply to the brain is blocked or disrupted, causing brain cells to be damaged or die. This can lead to disability or death. The earliest signs of stroke depend on which parts of the brain are affected and how severe the initial damage is. While one person might just feel a little weak on one side of the body, another might suddenly have trouble talking, walking, and seeing.

Dizziness and balance issues can be a result of a stroke, as it can affect the way your brain controls balance. You may feel unsteady or uncoordinated, and it may be difficult to sit up or stand. You may also find it difficult to walk, as you cannot lift your toes quickly enough, which is known as foot drop. This can make you feel unsteady and more likely to trip.

Vision problems are common after a stroke and can also contribute to balance issues. These problems can include difficulty focusing, double vision, and eye movement problems. If you are experiencing vision problems, it is important to see an optician, who can refer you for specialist help if needed.

If you are experiencing dizziness or balance issues, it is important to see a doctor or therapist, as these could be signs of a stroke or another underlying condition. Do not ignore these symptoms, as early treatment can improve your chances of recovery.

Frequently asked questions