When you have a stroke, your brain suddenly stops getting the blood and oxygen it needs. The most common cause is a blocked artery in your brain. Strokes also can be caused by bleeding in the brain, which not only disrupts normal blood flow, but also puts harmful pressure on brain tissues. In either kind of stroke, your brain cells can be damaged, potentially leading to disability or even death.
The earliest signs of stroke depend on which parts of your brain are affected and how bad 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.
When you see the following warning signs of a stroke, in yourself or someone else, it's important to get treatment right away. Every minute could make a difference how well someone recovers.
Identifying the Early Signs of a Stroke: The FAST Test
Because speedy recognition and action are so important when someone has a stroke, doctors have developed an easy-to-remember checklist for what to look for and what to do when someone shows possible warning signs.
It's called the FAST test. You can use it to check for the most common symptoms of a stroke in yourself or someone else.
F is for Face: Smile and see if one side of the face droops. That's a possible sign of muscle weakness or paralysis, which often show up on just one side of the body.
A is for Arms: Raise both arms. Does one arm drop down? That's another sign of one-sided weakness.
S is for Speech: Say a short phrase and check for slurred or strange speech. A stroke can make it hard for you to talk clearly or choose your words.
T is for Time: If the answer to any of these is yes, call 911 right away. Remember to look at the time and write down when you first saw any of these stroke warning signs.
Some health educators add two more steps to the checklist, calling it BE FAST. "B" stands for balance: loss of balance is a possible stroke sign. "E" stands for eyes: Someone having a stroke may suddenly lose vision in one or both eyes or have blurry vision.
Don't be tempted to drive yourself or someone else having a stroke to the hospital. Minutes matter in treating stroke. Calling a doctor or getting in the car wastes time. Ambulance workers can judge your situation sooner, and that boosts your chance of getting the treatment you need as soon as possible.
Other Warning Signs of a Stroke
Sometimes a stroke happens gradually, but you're more likely to have one or more sudden symptoms. While the FAST or BE FAST tests can alert you to the most common symptoms, the full list also can include:
- Numbness, especially on one side
- Confusion or trouble understanding other people
- Dizziness
- Clumsiness or poor coordination
- Trouble walking
- Severe headache that comes on for no reason
- Loss or dimming of any of your senses, including smell and taste
- Neck stiffness
- Personality changes
- Seizures
- Memory loss
- Passing out
If you have these symptoms or see them in someone else, call 911 even if you're not sure you're having or seeing a stroke.
Warning Signs of a Stroke in Women vs. Men
While the most common signs of stroke are seen in men and women, women are more likely to have certain symptoms, such as headache, weakness, and changes in thinking. Women also might have some more unusual symptoms, including:
- Hiccups
- Nausea
- Chest pain
- Fatigue
- Shortness of breath
- Racing heartbeat
Worldwide, women have a slightly higher lifetime risk of stroke than men do. Women also are more likely to die from them, largely because they tend to have more severe strokes later in life. They also are more likely to be misdiagnosed when they seek emergency treatment for stroke symptoms and to be more disabled after a stroke.
Warning Signs of Recurrent Strokes
Once you've had one stroke, you are at higher risk for another. The warning signs are the same.
Because you might have lingering effects from your first stroke, you and your caregivers might need to pay closer attention to see those warning signs.
It's a red flag if your symptoms change or shift from one part of your body to another, for example if:
- You've had slurred speech, but suddenly you also have trouble finding words
- You've been weak on one side, but now you are weaker or have weakness on the other side of your body
- You suddenly can't do something that was easy for you
Don't assume that you can't be having another stroke if you just had one: the risk of repeat strokes is actually highest in the days right after a previous stroke. Risks remain high for several months afterward.
It's just as important to get quick treatment for a possible second (third or fourth) stroke as it is for a first. Call 911.
Warning Signs of a Transient Ischemic Attack (TIA)
A transient ischemic attack, or TIA, is sometimes called a mini-stroke or warning stroke. That's because the symptoms come and go quickly, lasting anywhere from a few minutes to 24 hours. Most commonly the symptoms last 1 to 2 hours.
These mini-strokes are caused by a temporary loss of blood flow in your brain. They clear up without treatment and without causing lasting damage. But they are serious health events because a warning stroke is just that: It can mean you will have a full stroke soon, within days or weeks, if nothing is done to prevent it.
The symptoms of a TIA are the same as the symptoms of a stroke: things like one-sided weakness, slurred speech, or changes in vision. You can detect TIA symptoms with the FAST or BE FAST tests. In the first minutes, you won't know if you are seeing a mini-stroke or a full blown stroke, so you should call 911.
Even if the symptoms pass before you take action, you should treat the TIA as a medical emergency. Get help right away, so that doctors can confirm the TIA and help you prevent a damaging stroke. You might, for example, get blood thinning drugs to reduce blood clotting or have a procedure to clear a blocked neck artery. You might also need to make lifestyle changes or adjust medications to get better control of high blood pressure, diabetes, or other conditions that can contribute to a stroke.
Being Prepared for the Warning Signs of a Stroke
Each year, about 795,000 people in the U.S. have a stroke. It can happen to anyone at any time. Planning for an emergency can make a big difference.
Learn the signs. Learn the warning signs of a stroke and let your family and friends know, too. Make sure everyone knows that the best response to seeing possible stroke signs is calling 911.
Prepare children. If you have children in your home, teach them the FAST test, plus how to call 911, give your address, and describe what's happening.
Use medical IDs. If you have any medical conditions, wear a medical bracelet or other identification that lists them, your allergies, and any medication you take. And don't forget to put your medical information into the medical ID feature of your smartphone.
Takeaways
When it comes to recognizing and reacting to a possible stroke, just remember to be FAST -- looking for face drooping, arm weakness, and speech difficulties, then noting the time and calling 911. Do the same if you notice passing symptoms that look like a stroke. In either case, fast action can make a big difference.
Stroke Warning Signs FAQs
Does your body warn you before a stroke?
A transient ischemic attack (TIA) can warn you that a true stroke is coming. That's why you should always get immediate medical attention if you have brief signs of a stroke that seem to go away with no lasting harm. The same problems that caused those symptoms can cause a stroke.
Research also shows that some people report new or especially severe types of of headache in the days before a stroke.
What happens 1 month before a stroke?
There's no predictable time between a warning stroke (TIA) and a true stroke. But one long-term study going back to the 1940s found that nearly one-third of people who had a TIA later had a stroke and more than one-third of those strokes happened within a month. More than 20% happened within a week. But risks were much lower among people in the study who had their TIAs in recent years -- probably because of better recognition of those events and treatment of risk factors, such as high blood pressure.
What's the best treatment for a stroke?
It depends on the type of stroke you have. For strokes caused by blood clots, doctors may give you powerful clot-busting drugs. The treatment works best when you get this medication within 3 hours of when your symptoms started; in some cases, doctors will use it up to 4.5 hours after symptoms begin. You might also get a procedure to remove a clot from your brain. If your stroke was caused by a burst blood vessel, doctors will try to stop the bleeding as soon as possible. You might need surgery to reduce pressure on your brain.
