Stroke: A Medical Emergency and Its Early Warning Signs

Stroke is a critical medical emergency and ranks as the fifth leading cause of death globally. It often leads to long-term damage that significantly affects a patient’s overall quality of life. A stroke occurs when the supply of blood and oxygen to brain cells is interrupted for a sufficient period, causing cell death. [1]

This article will explore the early warning signs of a stroke and how to address the symptoms before it fully occurs.

Types of Stroke

Before delving into the symptoms that precede a stroke, it’s essential to understand the two main types of stroke: [1]

1. Ischemic Stroke: This type occurs due to a blockage in a brain blood vessel by a clot or thrombus, leading to disrupted blood flow to a specific brain area, causing damage. Ischemic strokes account for 85% of all stroke cases.
2. Hemorrhagic Stroke: This occurs when a blood vessel in the brain weakens and bursts, resulting in blood flow interruption and cell death.

Early Warning Signs of a Stroke

While a stroke happens suddenly, several warning signs may appear beforehand. It is crucial to seek immediate medical attention upon noticing these signs to prevent a stroke and its potentially permanent complications, such as chronic headaches, difficulty speaking, and muscle stiffness. The severity of complications varies depending on the extent of the stroke and the affected brain area. [2,3]

A critical warning sign is the Transient Ischemic Attack (TIA), often called a mini-stroke. TIA presents stroke-like symptoms that are temporary but serve as an alert for an impending stroke. Some of the early signs include: [3,4,5]

• Changes in facial features, such as drooping on one side of the face, including the corner of the mouth and cheek.
• Temporary memory loss, which can last for moments or up to a day, followed by a return to normal.
• Numbness and weakness in one part of the body, leading to sudden loss of grip or the inability to move a limb temporarily.
• Confusion and slurred speech, characterized by speaking unintelligibly or an inability to talk.
• Vision disturbances, like sudden vision loss in one or both eyes or changes in the visual field.
• Difficulty walking due to muscle spasms, loss of foot control, or impaired movement coordination.
• Dizziness and lightheadedness.
• Loss of balance and coordination.
• Behavioral changes.
• Severe headaches, especially preceding a hemorrhagic stroke, specifically a Subarachnoid Hemorrhage. Patients may experience the worst headache of their life, sometimes days or weeks before the stroke, due to minor bleeding from unhealthy vessels into the sensitive brain membrane, often accompanied by nausea, vomiting, neck stiffness, and blurred vision.

These symptoms usually disappear within an hour but can last up to 24 hours. Therefore, it is crucial to visit the hospital as soon as possible. Transient ischemic attacks (TIA) closely resemble stroke symptoms, but they differ in that TIA symptoms are temporary and resolve quickly, with the person returning to normal. This is because the blood supply to a specific brain area is cut off for a short period, insufficient to cause significant damage or cell death. In contrast, stroke symptoms are permanent and lead to disability and harm to the patient. [3,4]

About 17% of people who experience a stroke on the same day had a TIA earlier that day. TIA occurs in 9% of cases the day before the stroke. However, the majority, approximately 43% of stroke patients, experience TIA symptoms within the week (seven days) before the stroke. [6]

It is essential to note that stroke symptoms can sometimes be noticed by the patient or those around them before the stroke occurs. In some cases, a TIA can cause loss of consciousness or affect memory. However, those close to the patient may observe symptoms preceding the stroke. [3,4]

When a patient reports these symptoms, urgent intervention is needed to diagnose the condition and carry out appropriate medical procedures. Hemorrhagic stroke, especially subarachnoid hemorrhage, is fatal in many cases. [3,4]

How to Deal with Pre-Stroke Warning Signs

The appearance of any pre-stroke warning signs requires immediate medical attention. If the patient reaches the hospital within three hours of the first symptoms, the medical team can take necessary actions to dissolve blood clots and restore blood flow to the brain. Quick medical intervention improves the chances of full recovery and reduces the severity of potential disability caused by the stroke. [1]

Experts have devised a method to help patients and their families recognize the warning signs of a stroke and act quickly to get the patient to the hospital. This method is the FAST test, which consists of simple steps to help identify a stroke by the patient or others. [1,2]

When noticing stroke warning signs, it is advised to: [1,2,3,4]

• Look at the patient’s face and ask them to smile, checking for any drooping on one side.
• Ask the patient to raise both arms and check for weakness or drooping in one arm.
• Ask the patient to repeat a simple phrase, listening for slurred or strange speech that indicates a problem with the brain’s speech center.
• Waste no time and immediately call emergency services.

Factors That Increase the Likelihood of a Stroke

Several factors can increase a person’s risk of having a stroke, including:

1. A previous stroke or heart attack.
2. High blood pressure.
3. Diabetes.
4. Elevated cholesterol levels.
5. An unhealthy lifestyle, such as consuming unhealthy food, lack of physical activity, and not exercising regularly.
6. Obesity.
7. A family history of strokes.
8. Smoking.

Patients often experience symptoms or signs that precede a stroke, usually within the week leading up to it. Therefore, it is crucial for individuals, especially those with risk factors for stroke, to pay attention to any changes in their health. Family members should also be vigilant.

Recognizing the warning signs of a stroke and taking appropriate action in a timely manner can save a person’s life or help reduce the severity of disability and damage resulting from a stroke.