stroke

Signs and Symptoms of Stroke

Stroke is caused by an interrupted blood supply to a portion of the brain and can cause a variety of symptoms and signs. The most common strokes are hard to miss, but many people discount them, not realizing just how serious they are.

Strokes are treatable, so it is important to be able to recognize a stroke so that you can get the right emergency treatment as quickly as possible. If you see or experience any of the following symptoms and signs of a stroke, it’s important to get immediate medical help, as a stroke is an emergency.

Frequent Symptoms

Recognizing the symptoms of a stroke can save a life. The acronym FAST can help you remember them and what to do next:1

  • Facial drooping
  • Arm weakness
  • Speech difficulties
  • Time to call emergency services

stroke symptoms

Facial Weakness

Weakness in facial muscles as a symptom of stroke manifests as drooping of one eyelid or sagging of one side of the face. Sometimes one side of the face appears to be flat and the mouth may curve down. The tongue may also be affected, with the inability to move the tongue to one side of the mouth.2

Arm or Leg Weakness

Weakness of the arm, the leg, or both is a common stroke symptom. When a stroke causes physical weakness of the extremities, it typically affects only one side of the body.3

You may notice partial weakness, which means that you do not have full strength, or complete weakness to the point of not being able to move the limb at all. Arm weakness may cause you to drop items or may make you unable to reach for objects. Sometimes mild leg weakness can cause you to lean toward one side, while severe leg weakness can make you fall down.

Slurred Speech

Slurred speech may be more noticeable to others than to the person having the stroke. Frequently, slurred speech is associated with drooling and is often related to facial weakness.4

Falling

Leg weakness can result in falling—a startling event that may cause injury. Therefore, if you notice someone fall down and there is any chance that they can’t get up without assistance, or suffered a head bump, it is critically important to call for help.

A set of exercises for rehabilitation of post-stroke patients. Set No1 is  aimed at improving the functions associated  with mobility in bed.

For additional information about the rehabilitation after a stroke you can watch a video demonstrating exercises and rehabilitation recommendations.

Loss of Vision

Visual loss from a stroke can manifest in a number of different ways that cut off vision in only half of one eye or in one-half of both eyes, often referred to as hemianopsia.5 It can be the top/bottom half of one eye, a whole eye (amaurosis fugax) or the left/right half of both eyes.

Hemianopsia is painless, but it is disturbing and may cause you to blink your eyes as you try to figure out what is going on with your vision. If you suddenly experience vision loss, you need to get help—even if you can see a little bit or if you can see out of the sides of your eyes.

Language Problems

Sudden language problems are among the hallmark symptoms of stroke. Aphasia, a deficit in language, may manifest as trouble producing fluent or coherent words and phrases, trouble understanding written or spoken language, or a combination of any of these problems.6

Severe Headache

A stroke does not always cause a headache, but a severe headache can signal a stroke, particularly a hemorrhagic stroke. A sudden, severe headache that is different than your usual headaches may be a symptom of a stroke, particularly if there are other associated symptoms such as visual changes or weakness.7

Confusion

A stroke can cause confusion due to the effect it has on the brain.8 Sudden confusion, disorientation, or forgetfulness may be a symptom of stroke or another medical emergency.

Dizziness

Dizziness, a sense of instability, and wobbliness are all possible symptoms of stroke.8 If you experience a sense that you cannot hold yourself up or that you or your surroundings are spinning, it is important to get medical attention.

EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №2 IS AIMED AT IMPROVING THE MOBILITY AND STABILIZATION OF THE PELVIC COMPLEX

Rare Symptoms

Less common symptoms of a stroke include:

Incontinence

Bladder and bowel control require a sophisticated interaction between several regions of the brain. Sudden incontinence is not typically the first symptom of a stroke, but it may be the first noticeable indication of a stroke in some instances.9

Numbness, Tingling, or Sensory Loss

Sensory problems such as tingling or numbness, or the inability to feel your face, arm, or leg may be the first symptom of a stroke.8 Typically, a stroke causes more prominent concerns, but sudden sensory problems, while less common, can be the first symptoms that appear.

Strange Sensations

Unusual sensations may be the first symptoms of stroke. Overall, skin burning or crawling sensations are typically signs of neuropathy, not a stroke. However, neuropathy develops slowly over time. Sudden disturbing sensations are concerning and may signal a stroke.10

Change in Vision

Most of the time, visual changes signifying a stroke fall into the category of visual field cuts. However, there are some other visual change patterns as well, including loss of vision in only one eye and loss of color vision.11

Visuospatial neglect is hard to recognize in one’s self, but others will see an inability to attend to one-half of space, usually the left.

Hiccups

Any posterior stroke can cause hiccups if it causes swelling. Persistent hiccups can be the most noticeable and bothersome symptom of a small stroke in the brainstem. The other symptoms of this type of brainstem stroke, called Wallenberg syndrome, include dizziness, nausea, vomiting, problems with balance, coordination of one side of the body, and sensory deficits.12

Coordination Problems

A stroke does not usually target coordination. However, a type of stroke called a cerebellar stroke may produce coordination problems that are more prominent than weakness or other symptoms.13

Cognitive Deficits

A stroke can interfere with concentration, memory, and learning. A deficit in thinking skills and dementia-like symptoms are usually more long-term effects of a stroke, rather than symptoms of a new one.14 However, a new stroke can cause sudden cognitive problems, particularly if silent strokes have already had a quiet impact on brain reserve.

A SET OF EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №3 IS AIMED AT IMPROVING THE MOBILITY AND FUNCTION OF THE UPPER LIMB, STABILIZING THE SHOULDER GIRDLE

Complications

After a stroke, symptoms typically stabilize and often improve. However, new symptoms such as seizures, spasticity, muscle atrophy, depression, and swallowing problems may develop.

Long-term effects of a stroke can include the following, some of which are perpetuations of the very symptoms that presented with its arrival:8

  • Weakness of one side of the body
  • Weakness of one side of the face; a droopy eyelid
  • Vision loss or partial vision loss
  • Double vision or blurred vision
  • Slurred speech
  • Trouble understanding words or trouble with language
  • Balance and coordination problems
  • Loss of sensation of one side of the body or face
  • Lack of awareness of your surroundings or of your own body
  • Difficulty with problem-solving
  • Dizziness, headaches, and pain
  • Urinary incontinence

Recovery after a stroke can take time. Before it’s possible to assess any permanent damage that has occurred, the brain needs time to heal. Many stroke patients undergo physical or occupational therapy to regain skills they may have lost as a result of the stroke.

A SET OF EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №4 IS AIMED AT IMPROVING THE MOBILITY AND FUNCTION OF THE LOWER LIMB, STABILIZING THE PELVIC GIRDLE

When to Go to the Hospital

If you experience or witness someone with any of the symptoms of a stroke, call emergency services and get to a hospital without delay. Stroke is treatable in the first few hours after symptoms begin. Even strokes where the symptoms began overnight can sometimes be candidates for treatment.

Treatment requires a trained medical team that can act quickly to administer powerful medications that can reduce or reverse the obstruction of blood flow before it causes permanent brain damage.

Frequently Asked Questions

  • What is a silent stroke?

    A silent stroke is a stroke that goes unnoticed until identified on on a a CT or MRI. Doctors are able to tell the difference between recent and older strokes based on certain characteristics that appear in these scans.15

  • How are strokes treated?

    Depending on the type of stroke and how quickly someone arrives at the hospital after the first sign of stroke, the patient may receive medication to break up blood clots. Endovascular procedures are another treatment option, in which a doctor inserts a long catheter through the groin to damaged blood vessels to repair the weakness or break. Surgical treatments to fix ruptures may also be used to treat certain types of stroke.16

By Heidi Moawad, MD
Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.
  1. Centers for Disease Control and Prevention. Signs and symptoms of stroke.
  2. Wei CC, Huang SW, Hsu SL, Chen HC, Chen JS, Liang H. Analysis of using the tongue deviation angle as a warning sign of a strokeBiomed Eng Online. 2012;11:53. doi:10.1186/1475-925X-11-53
  3. National Institute on Aging. Stroke.
  4. Eissa A, Krass I, Levi C, Sturm J, Ibrahim R, Bajorek B. Understanding the reasons behind the low utilisation of thrombolysis in strokeAustralas Med J. 2013;6(3):152-67. doi:10.4066/AMJ.2013.1607
  5. Goodwin D. Homonymous hemianopia: challenges and solutionsClin Ophthalmol. 2014;8:1919-27. doi:10.2147/OPTH.S59452
  6. National Institute on Deafness and Other Communication Disorders. Aphasia.
  7. National Institute of Neurological Disorders and Stroke. Signs and symptoms.
  8. National Heart, Lung, and Blood Institute. Stroke.
  9. Yanagawa Y, Yoshihara T, Kato H, Iba T, Tanaka H. Significance of urinary incontinence, age, and consciousness level on arrival among patients with stroke. J Emerg Trauma Shock. 2013;6(2):83-6. doi:10.4103/0974-2700.110750
  10. National Institute of Neurological Disorders and Stroke. Stroke: Hope through research.
  11. Rowe FJ. Vision In Stroke cohort: profile overview of visual impairmentBrain Behav. 2017;7(11):e00771. doi:10.1002/brb3.771
  12. National Institute of Neurological Disorders and Stroke. Wallenberg’s syndrome.
  13. Konczak J, Pierscianek D, Hirsiger S, et al. Recovery of upper limb function after cerebellar stroke: lesion symptom mapping and arm kinematicsStroke. 2010;41(10):2191-200. doi:10.1161/STROKEAHA.110.583641
  14. Al-Qazzaz NK, Ali SH, Ahmad SA, Islam S, Mohamad K. Cognitive impairment and memory dysfunction after a stroke diagnosis: a post-stroke memory assessmentNeuropsychiatr Dis Treat. 2014;10:1677-91. doi:10.2147/NDT.S67184
  15. Gupta A, Giambrone AE, Gialdini G, et al. Silent brain infarction and risk of future stroke: a systematic review and meta-analysisStroke. 2016;47(3):719-25. doi:10.1161/STROKEAHA.115.011889
  16. Centers for Disease Control and Prevention. Treatment and intervention for stroke.
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