Stroke is one of the most common neurological disorders. Someone in the United States has a stroke every 40 seconds, and someone dies from a stroke every 3.5 minutes, according to the Centers for Disease Control and Prevention (CDC).

But the signs and symptoms of a stroke are often misunderstood. Here’s what you need to know.


What is a stroke?

There are two main types of stroke: ischemic and hemorrhagic. Ischemic stroke occurs when there is a clot or blocked blood vessel, while a hemorrhagic stroke occurs when a blood vessel bursts. Ischemic strokes are more common than hemorrhagic strokes.


What are the symptoms of a stroke?

Summit Health neurologist Terry Rolan, MD, explains that any sudden onset of a neurologic symptom is a potential sign of stroke. This includes:

  • Visual disturbance like blurred vision, loss of vision, or double vision
  • Slurred speech or difficulty speaking
  • Unsteady gait, change in balance, or dizziness
  • One-sided numbness or weakness

“The symptoms of stroke depend on which part of the brain the stroke is occurring in,” he says.


How do you know if someone is having a stroke?

Many times, you can tell someone is having a stroke just by observing their behavior. The acronym BE FAST is a tool that can help you remember the signs and symptoms of a stroke.


  • B – Balance.
    • Is the person having trouble with balance or coordination?
  • E – Eyes.
      • Is the person experiencing blurry vision, double vision, or sudden loss of vision in one or both eyes without pain?
  • F – Face Drooping.
    • Is one side of the face drooping or numb? Can the person properly smile?
  • A – Arm Weakness
    • Is one arm weak or numb? Can the person raise both arms? Observe if one arm drifts downward.
  • S – Speech Difficulty
    • Is the person experiencing slurred speech or unable to speak? Are they hard to understand?
  • T – Time to call 911

“When it comes to stroke, every minute counts, and time is brain! If you think someone is having symptoms of a stroke, the best thing to do is immediately call 911. The earlier you come in for treatment the more options you have,” says Dr. Rolan.


What are the risk factors for stroke?

The most common risks for stroke include:

  • Heart disease
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Obesity
  • Dependency on drugs, alcohol, or cigarettes
  • Family history of stroke
  • History of a prior stroke

Your risk factors for stroke change according to age, race, and gender. After age 55, the risk for stroke doubles in everyone. Men also have a higher risk of stroke, but the risk increases for women between the ages of 35 and 44, and then again after 85 years old due to:

  • Pregnancy
  • Preeclampsia/eclampsia – a complication during pregnancy that causes high blood pressure
  • Gestational diabetes
  • Oral contraception
  • Post-menopausal hormone therapy


What are silent strokes and TIAs?

“During a silent stroke the patient may not have any symptoms because that area of damage is small or occurs in a part of the brain that doesn’t control vital functions,” explains Dr. Rolan. “Oftentimes the only reason we know a silent stoke has occurred is because imaging of the brain (on MRI or CT) shows evidence of a prior stroke.”

TIA stands for transient ischemic attack. This means a patient had signs or symptoms of a stroke while it was in progress, but they resolved without damaging the brain. Some people may use the term “mini-stroke” to describe a TIA, but neurologists like Dr. Rolan say it’s not an accurate description because it can refer to either the severity or duration of the stroke.

Dr. Rolan urges patients to take TIAs as a warning sign for a major stroke. “The incidence of another stroke is highest in the 3 months following a TIA, so it’s critical that patients or a patient’s family report these events to a medical professional,” he says.


How is a stroke treated?

Treatment for stroke depends on how quickly the patient arrives at a hospital. “Some treatments can be given only if the patient presents within a certain time window,” explains Dr. Rolan. For example, one of these treatments, tPA (tissue plasminogen activator), more commonly known as the “clot-buster,” is only given within the first 4.5 hours.

Another option, mechanical thrombectomy, is a surgical procedure that uses a guided wire to remove the clot and restore blood flow. “This option is considered in certain cases up to 24 hours from onset of symptoms,” says Dr. Rolan.


How Summit Health can help 

Patients who have a history of stroke are more likely to have another one. If you have had a stroke or are at a very high risk of developing one, it is important to be followed by a neurologist. Our specialists can help patients lower their risk factors for stroke.


If you or a loved one show any signs or symptoms of stroke call 911 or visit the nearest emergency room immediately. The earlier you seek out treatment, the more options you will have for treatments and the better long-term outcomes you will have. Make an appointment with a neurologist at Summit Health if you have a history of previous strokes or are at high risk for developing strokes.