A stroke is a medical emergency. The best available stroke treatments, such as tissue plasminogen activator (tPA), are more effective than those previously given and, after a few hours, can be completely useless. For this reason, it is very important to recognize the symptoms of a stroke and go to the emergency room immediately if you suspect you have one.
Symptoms of a stroke
Stroke symptoms start suddenly and can include any of the following:
- Difficulty walking: This may be due to poor balance, weakness, clumsiness, or dizziness.
- Communication difficulties – You may not understand what other people are saying. You may not be able to form the words you would like to say and you will lose the ability to write. Your speech can become confusing and difficult to understand.
- Numbness or weakness on one side of the body or face – This can range from complete paralysis to the more subtle difference between holding the left and right arms up. Due to the weakness of the face, one side may appear lowered.
- Loss of coordination on one side of the body: While your limbs may be strong, you may not have the coordination to do something you could previously do, such as holding a spoon or fastening a clasp. In rare cases, a part of the body may develop abnormal spontaneous movements.
- Vision problems: This can include double vision or loss of vision in one or both eyes.
- Severe headaches: Most strokes do not cause headaches, but if the headache comes on suddenly, is severe, or is associated with vomiting or decreased consciousness, it may be due to a stroke.
- Seizures: Most seizures are not due to a stroke. On the other hand, strokes are a common cause of new seizures in people over the age of 60 who have had no previous seizures.
How long do the symptoms last?
The duration of the symptom depends on the size and severity of the stroke . Symptoms can last less than an hour, but can persist for a lifetime. Even if the physical damage caused by a stroke is not corrected with treatment, sometimes the brain can "realign" itself to find new ways to transmit information to restore function. The longer a symptom lasts, the more likely it is to remain permanent, so it is imperative that you address problems caused by a stroke as soon as possible.
What to do if the symptoms have disappeared
Even if the symptoms go away, an exam should be done as soon as possible. Transient ischemic attacks (TIAs) are a type of stroke caused by a temporary loss of blood flow to part of the brain. For example, a clot could have lodged in an artery and blocked blood flow, but now it has disintegrated and passed through. Although blood flow may have recovered on its own, you are at higher risk for another episode with persistent symptoms.
What to do if you think you have a stroke
Dial 911. If you cannot speak clearly, ask someone to help you. The sooner you get to the emergency room, the more likely your stroke will have no long-term consequences.
Aspirin and other medications
Don't worry about taking aspirin or other medications. It is more important to go to the emergency room right away. About 85% of strokes are ischemic, which means that the clot stops the movement of blood to parts of the brain. For these strokes, medications like aspirin help. However, 15% of strokes are caused by bleeding in the brain , in which case aspirin makes the situation worse. Before taking any medicine, it is best to get tested with a healthcare professional to find out what type of stroke you have.
What happens in the emergency room
When you get to the emergency room, doctors will want to quickly decide if you have a stroke and if it is safe to give you a blood thinner like tPA. They can ask the following questions to help them make a decision:
- When was the last time you felt normal? Did you wake up with these symptoms or do you remember the exact time they started? (This definition is especially important when doctors decide whether or not to administer tPA.)
- What is your medical history? Do you have risk factors for stroke, such as diabetes or smoking? Have you had a stroke before?
- Do you have a bleeding or clotting disorder?
- Have you had bleeding in the brain before? Have you had a recent surgery or physical injury?
- What medications do you take?
- Is there metal on your body, such as clamps or equipment? Are you claustrophobic? These questions are important in determining the safety of MRI.
Remember, a stroke is an emergency and every minute counts. It is best if you are in the emergency room within an hour after the first symptoms. If you are in any doubt that you may have a stroke, you should speak to your doctor immediately.