Talk about a brain teaser.
While the obvious signs of a stroke are easy to spot, there are several subtle symptoms that can slip under the radar. But don’t let them deceive you.
“All symptoms of stroke, no matter how severe or how long they last, are important,” Dr. Laura Stein, a vascular neurologist, educator and stroke health services researcher at Mount Sinai, told The Post.
Stein broke down the red flags you should never ignore — and explained why calling an ambulance isn’t just smart, it could be the difference between walking out of the hospital or never walking again.
But first: What is a stroke?
It’s a medical emergency where blood flow to the brain is cut off, depriving brain cells of oxygen and nutrients. This disruption can occur either from a blockage, such as a blood clot, or from bleeding within the brain.
There’s also a mini-stroke, called a transient ischemic attack (TIA), which involves a temporary disruption of blood flow that mimics stroke symptoms but usually resolves within a few hours or days.
But don’t be lulled into a false sense of calm by the “mini” label. Stein said that the stakes are “incredibly high,” warning that people who experience a TIA are at a “very high risk” of having a full-blown stroke — both in the short and long term — if left untreated.
The big, scary signs of stroke
Stein said sudden weakness or numbness on one side of the body is one of the most obvious signs of a stroke.
“For instance, someone may suddenly experience drooping of the face, difficulty lifting their arm, and difficulty lifting their leg,” she explained.
Another alarming symptom is sudden difficulty speaking, understanding or communicating.
“This could be slurred speech, words that sound like gibberish, or apparent confusion with difficulty finding words or understanding what is being communicated,” Stein said.
The sneaky, sometimes silent signs
Some stroke symptoms fly under the radar. Stein said dizziness, imbalance or incoordination — think drunk without drinking — could all be warning signs.
Changes in vision, like double vision or losing sight in one or both eyes, can also point to a stroke, she said.
Even some of the more obvious stroke symptoms can show up more quietly.
“For instance, weakness or numbness might be mild, such as a drooping face or slurred speech, but the person can still hold things and walk,” Stein said.
She noted that with these subtle symptoms, the person experiencing them might not even realize it, making it crucial for those around them to step in and take action.
“Any sudden change in a person’s normal neurological function should be assumed to be a stroke until proven otherwise,” Stein said. “Even if symptoms last only seconds, they can be a warning of potential permanent brain damage.
Remember: BE FAST
Stein said that doctors use this simple acronym to help remember the signs of stroke.
- Balance: Sudden loss of coordination
- Eyes: Blurry, double, or lost vision
- Face: Drooping or uneven smile
- Arm: Weakness or numbness
- Speech: Slurred, confused, or hard to understand
- Time: Call 911 immediately
Don’t drive — dial 911
“Calling 911 is always the fastest and most effective way to get someone treated for stroke,” Stein said.
The second blood flow to the brain is interrupted, brain cells begin to die, she explained.
“Every minute that goes by increases the chance of permanent brain damage and that a patient will not be able to do the things we take for granted every day, such as get dressed, eat, walk and talk,” Stein said.
She also noted that each hour a stroke goes untreated, aging accelerates by more than three years. Most people have just 4.5 hours to receive clot-busting medication to reverse the symptoms of a stroke, she explained.
“The earlier they get that medication or have the clot pulled out of their brain, if eligible, the more likely they are to reverse the symptoms and return to doing the things they did before their stroke,” Stein said.
In New York City, a small number of stroke ambulances are equipped to administer clot-busting medication on the spot for faster treatment.
But even if you’re not in a stroke ambulance, NYC ambulances have protocols to get patients directly to the best hospital for the care they need.
That’s crucial, Stein explained, because depending on the type of stroke, only certain hospitals are equipped to provide the necessary care. If you drive yourself, you could end up at a facility that isn’t capable of treating you effectively.
Ambulances also notify hospitals that they’re bringing in a potential stroke patient, allowing the stroke team to swiftly evaluate and treat them upon arrival.
What to do while you wait
“It’s important for the stroke team to know what medications a patient is taking and when they last took them,” Stein explained.
While waiting for first responders, she recommended gathering a list of medications, a pillbox or pill bottles.
“That information can help the stroke team quickly decide if a patient is eligible for our clot busting treatment,” Stein said.
“Otherwise, make sure your loved one is safe and comforted, but do not give them medication on your own because it may actually harm them rather than help them,” she added.
How to prevent stroke in the first place
“The seriousness of stroke cannot be overstated, and the best way to treat a stroke is by preventing one,” Stein said.
In the US, someone suffers a stroke every 40 seconds, and more than 7 million people are stroke survivors. It’s a top driver of disability and the fifth leading cause of death nationwide.
Over the course of our lives, the chance of experiencing a stroke is about 25%. But Stein said there are steps you can take every day to reduce that risk.
“The most important thing you can do is ensure your blood pressure is normal,” she said. That means keeping it under 130/80.
If your blood pressure is high, Stein said there are several effective medications to help lower it. Weight loss can also play a significant role in managing and preventing high blood pressure.
Other ways to reduce your stroke risk and promote brain health include maintaining a healthy diet, exercising regularly, managing high cholesterol, controlling blood sugar, and quitting smoking and drinking alcohol.