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How to Recognize a Warning Sign of Stroke?

Written by
Dr. Talati Vidhi Hareshbhai
and medically reviewed by iCliniq medical review team.

Published on Feb 09, 2016 and last reviewed on Apr 28, 2022   -  5 min read


Stroke is the third leading cause of death today. There are many complications associated with a stroke, which will disturb the day-to-day activities of a person or the family members. Every person must be aware of the signs and symptoms of stroke to save the patient's life. For better protection, a person should know the risk factors of stroke, how to reduce the risk factors, warning signs, and what to do if warning signs appear.

How to Recognize a Warning Sign of Stroke?

Stroke is also referred to as a cerebrovascular accident (CVA) or brain attack. It means that there is an insult or disturbance in the blood supply of the brain, which leads to neurological function loss. Stroke may cause permanent disability to one or two or all four extremities.

Complications with stroke are abnormalities found with vision, paralysis (inability to move the limb or complete flaccidity) or paraparesis that is, weakness of muscles in one or more extremities, difficulties in speech such as difficulties found in formulation and understanding, gait abnormalities, severe headache, confusion, sudden loss of balance, etc. Hemiplegia - paralysis of one side of the body is a major drawback of stroke. Post-stroke disability is the major complication of stroke.

Types of Stroke:

Hemorrhage (bleeding due to injury) and ischemia (lack of blood supply) are the major causes for the disturbance of blood supply in the brain.

  • Ischemic stroke occurs mainly due to the blockage of any major artery which supplies brain. This blockage prevents blood flow to the brain, and it is responsible for major permanent damage to brain tissue, which in turn will lead to neurological insult. Ischemic stroke is a very common type affecting 80 % of individuals with stroke. Due to blockage, brain deprives for necessary oxygen and nutrients.
  • Hemorrhagic stroke refers to bleeding from blood vessels of the brain inside or outside the skull. When blood vessels rupture it will cause extravasation of blood.

Signs and Symptoms of Stroke:

Signs and symptoms of stroke depend upon the area of the brain affected. The most common areas involved in developing stroke are anterior cerebral artery, middle cerebral artery, internal carotid artery, posterior cerebral artery (lacunar syndrome), vertebrobasilar artery, etc. In stroke, many focal deficits are present such as changes in the level of consciousness and abnormal motor, sensory, cognitive, perceptual, and language functions.

Risk Factors for Stroke:

Some of the major causes responsible for stroke are as follows:

  1. High blood pressure.
  2. High cholesterol.
  3. Positive family history.
  4. Diabetes mellitus.
  5. Cardiovascular diseases.
  6. Obesity.
  7. Atrial fibrillation.
  8. Congestive heart failure.
  9. Peripheral vascular disease.
  10. Surgery.
  11. Excess alcohol consumption.
  12. Lack of exercise.
  13. Tobacco smoking.
  14. Age of above 55 years.
  15. African and American races.

Warning Signs of Stroke:

Early warning signs given by the National Stroke Association are as follows:

1) Transient Ischemic Attack (TIA):

  • Sometimes stroke occurs without any symptoms, but sometimes with some early signs which are referred to as transient ischemic attack. It is also known as mini strokes.
  • It may last for a few seconds to a few minutes and not more than 24 hours. It may originate from emboli, reduced cerebral perfusion (less blood circulation in the brain), due to arrhythmias (abnormal cardiac rhythm), reduced cardiac output, hypotension, overdose of antihypertensive medication, etc.
  • It does not cause any permanent damage. The damage is totally reversible. It may give you a warning that you should not take it easy.
  • Approximately 20 % of patients with TIA will go on to have a major stroke within 90 days and 2 % will have a major stroke in 2 days.
  • Every minute counts. Contact the emergency number provided by the government of any country for immediate treatment.

2) High Blood Pressure:

High blood pressure increases four to five times the risk of stroke. If blood pressure is above 160/95 mmHg, then it is a warning sign for stroke.

  • The person may feel sudden confusion, difficulties in speaking, pronunciation and understanding the words. This type of speech is referred to as slurred speech.
  • Difficulties found with vision in one or both eyes. The patient may find it difficult while walking and will feel dizzy. The patient cannot maintain balance properly. Coordination of movement also becomes difficult prior to a stroke.
  • Severe headaches may appear suddenly, without any known cause. Sometimes the person may feel nausea, vomiting, and fever for some minutes or hours or several days. Fainting may appear just prior, a few seconds, before developing the stroke.

3) Weakness of Limb or Side of the Face:

  • Patients found numbness over face and weakness over extremities like arms and legs. It may be confined to one side of the body.
  • Furthermore, patients cannot move their limb voluntarily. Problem found with lifting any objects.
  • Facial drooping is also a sign of stroke. The reason behind this is the incomplete cessation of the blood supply to a part of the brain. The blood tries to force its path through the blocked artery.
  • If a person has these signs, immediately go to the hospital and check for embolus block (atherosclerotic plaque that blocks the artery). This may be life saving.
  • Presence of arm drift confirms the diagnosis. Arm drift means when a patient raises both his hands simultaneously, one hand suddenly drops in a downward direction.

The above-stated signs may appear before a stroke. Person and his relatives are encouraged to call the emergency department, even if these symptoms go away quickly and are painless. When you find these symptoms, please note the time, as this information is very important for doctors.

During a stroke, time is everything. Stroke needs immediate emergency treatment to prevent permanent focal defects in the brain. Morbidity and mortality rates are high with stroke. If treatment is not given as early as possible, chances for disabilities are more.

How to Diagnose a Stroke?

  • Computed tomography (CT) in early stage is used to differentiate the type of stroke. It may be atheroembolic stroke or hemorrhagic stroke.
  • Magnetic resonance imaging (MRI) study is also useful to diagnose stroke.

Management After the Appearance of Warning Signs:

If a patient gets stroke due to atherothrombotic reason, then the person should take a clot-dissolving enzyme such as Tissue plasminogen activator [tPA] 50 - 100 mg once daily or Urokinase or Prourokinase. tPA should be administered within 3 hours of the onset of signs and symptoms of stroke. It must be used in atherothrombotic stroke. It is strongly contraindicated in hemorrhagic stroke because it may increase blood loss. Researchers have proved that a person who was treated with tissue plasminogen did not get any disability or minimum disability as compared to those who did not receive the treatment.

  • Improvement in cerebral perfusion is established by proper circulation and oxygenation. It can be delivered by a mask or cannula.
  • Electrolyte balance and restoring fluid is an integral part of management.
  • Anticoagulant therapy is initiated with Heparin or Coumadin (5000 units SC q8-12 hour or 7500 units SC q12 hour) to improve circulation and to reduce the risk of developing embolus. Low dose 2 mg of Heparin once a day is used for this purpose.
  • Antiplatelet therapy with Aspirin (50 to 325 mg orally once a day) is initiated as soon as possible. Low dose is used to prevent second attack. High dose with 5 mg may be used to treat atrial fibrillation.
  • Ticlopidine (250 mg twice daily with food) or Clopidogrel bisulfate (75 mg orally once daily) is another agent used to prevent recurrent attacks.

The above-stated medications are used in emergency treatment. Right recognition, right decision, right treatment at right time may save an individual’s life!

If you would like to gather more information about the warning signs of stroke and its emergency management then consult a stroke specialist online -->

Frequently Asked Questions


What Are the Four Early Warning Signs of Stroke?

The silent signs of stroke can be known by understanding the mnemonic “FAST,” which means 
- Face - To check the drooping of the face.
- Arms - Raise both arms and notice if one drops down. 
- Speech - Check for slurred or strange speech.
- Time - If any of the signs is present, call the emergency number without any delay and note down the time when symptoms first started.


What Is the First Classic Sign of Stroke?

The very first signs of stroke are sudden numbness or weakness in the face, arm, or leg, usually only on one side of the body. Followed by other symptoms, which include sudden confusion, trouble speaking, and impaired vision in one or both eyes. Moreover, patients experience difficulty in walking, dizziness, loss of balance, or lack of coordination.


What Does Water Do in the Prevention of Stroke?

Drinking enough water regularly can prevent stroke by avoiding dehydration. A person should drink a minimum of five glasses per day which can reduce the risk of stroke by 50 %. The water helps in keeping the blood less viscous, thus preventing stroke.


What to Do if Someone Has a Stroke?

Some of the steps can be followed if the person is having a stroke - call an emergency number or call for help, then note the time of onset of symptoms, perform CPR (cardiopulmonary resuscitation) if needed, ensure the patient does not sleep, do not give any food, drinks or medicines and do not let the patient drive alone or go to the emergency room by himself.


How Much Time Does It Take for Symptoms of Stroke to Appear?

The warning signs of stroke may appear as early as a few hours to a week before the attack. And if a person notices any of the signs, they should go for urgent treatment to prevent any brain damage or other complications.


What Are the Main Causes of Strokes?

Some of the main causes of stroke are high blood pressure (hypertension), high cholesterol, smoking, obesity, and diabetes. Other factors such as age, race, family, gender, and some medications can also increase the risk of stroke.


What Are the Symptoms of Stroke-Related Headaches?

A stroke can cause sudden and severe headaches, which is the only painful symptom noticed by the person. Around 10 to 60 % of the people undergoing stroke can experience this symptom. And it is also difficult in some cases to differentiate between the pain of stroke-related headaches and migraine.


Can Stroke Goes Away on Its Own?

Stroke symptoms can go away on their own, but it is still a medical emergency, and the patient should get medical advice as soon as possible. Because every stroke is a medical emergency. During a stroke, the blood flow to the brain gets interrupted, which can cause the death of brain cells.


Who Has a Higher Chance of Getting a Stroke?

There are various reasons which put you at risk of stroke, which includes being overweight, drinking habit, smoking, high blood pressure, high cholesterol, diabetes, obstructive sleep apnea, cardiovascular diseases such as heart defects, infection or irregular heartbeat, and a history of stroke in the family.


For How Long Do Stroke Symptoms Stay?

The stroke can last for a few minutes to 24 hours. Some symptoms may resolve immediately which is generally common, but in some cases, the patient may experience symptoms for up to 24 hours and which may still persist even after receiving treatment.


What Activities in the Bathroom Can Lead To Stroke?

Some of the factors that can lead to stroke in the bathroom are toilet strain during defecation, no sequenced bath or shower (wetting of head or hair first), water temperature (cold water in winter is one of the causes of stroke), and slipping in the bathroom can cause injury to head and cause bleeding.


What Is a Wake-up Stroke?

A wake-up stroke occurs during sleep. In this condition, the person goes to bed feeling normal but wakes up with stroke symptoms. Wake-up stroke is the same as other strokes but turns out to be more dangerous as the onset of symptoms is unknown, and the treatment is delayed as the patient is sleeping.

Last reviewed at:
28 Apr 2022  -  5 min read




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