Signs of stroke

The signs and symptoms of stroke, as a rule, occur suddenly.   A stroke may affect different functions and commonly involve any of the following:

  • Motor:  weakness on one side of the body
  • Sensory:  Numbness or tingling in the face, arm, and/or leg
  • Speech: Loss of speech, trouble understanding speech, or slurring of speech
  • Visual: Loss of vision, particularly from one eye or double vision
  • Gait and balance:  Dizziness and loss of balance
  • Severe and unusual headache

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When to suspect a stroke

There is an easy way to suspect whether someone is having a stroke or not.  Using the FAST acronym, one may easily remember the 4 items to check:

F= Face:               Ask the person to smile or show his teeth; check for droopiness of one side

A= Arms:             Ask the person to close his eyes and hold both arms out front; check for drifting down of one side or inability to lift one side

S= Speech           Ask the person to repeat a phrase (like “You can’t teach old dogs new tricks”); check for slurring of speech or inability to complete the phrase

Difficulty in performing any of these items may indicate that the person may have suffered a stroke, in which case it is important to check for…

T= Time                                Determine what time the stroke signs or symptoms started

 

If a stroke is suspected, it is very important that the person is brought to the hospital immediately for appropriate treatment.  Early initiation of stroke-specific treatments gives a stroke victim the best chance of improved long-term outcome.

 

Diagnosis of stroke

While some signs and symptoms of stroke may be more common than others, they may not necessarily be the same for all stroke patients.  The diagnosis of a stroke, therefore, is based on the clinical judgment of the doctor.  There are certain tests, however, that would help the doctor confirm his diagnosis and guide him on the choice of treatment.  Not all procedures or tests are necessary for all patients.  The doctor will decide which tests are medically indicated and would be helpful in each particular case of stroke.

Brain imaging (either CT scan or MRI)

Among the first few information about the stroke that a doctor needs to treat a patient is to find out whether the stroke is ischemic (due to a blockage in blood flow) or hemorrhagic (due to bleeding).  This is because the treatment is almost contradictory between the two.  Clearing the blockage by dissolving the clot may be important in  ischemic strokes, while stopping the bleed would be important in hemorrhagic strokes.

Brain imaging would also help assess how much of the brain was affected by the stroke and to determine if another brain condition other than stroke could account for the patient’s signs and symptoms.

Other diagnostic tests

Other tests are performed to find out the reason(s) for the stroke.  These tests would check whether there are underlying medical conditions that could have increased the risk of having a stroke in the patient, with the objective of correcting any identified risk factors [link to risk factor section] to reduce the chance of suffering another stroke in the future.

Blood tests can determine if there is high cholesterol level, diabetes, clotting problems, or other systemic conditions that could be contributing to the occurrence of stroke.  Heart tests, like electrocardiogram (ECG) or echocardiogram, may be performed to look for underlying cardiac problems associated with clot formation in the heart chamber.  The carotid arteries and blood vessels to the brain may be assessed by either ultrasound or special scans.