Stroke: Recognising FAST and Why Every Minute Counts
Around 1.9 million brain cells die every minute during a stroke. Recognising three simple signs and calling 108 immediately is the difference between recovery and lifelong disability.
Read articleA stroke is a sudden interruption of blood supply to part of the brain, either from a clot or from bleeding. Treatment that can reverse the damage works only within a narrow window from the moment symptoms begin, so a stroke is an emergency in exactly the way a heart attack is.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Sudden weakness or numbness of the face, arm or leg, usually on one side
- Drooping of one side of the face — the FAST test
- Slurred speech, or difficulty finding or understanding words
- Sudden loss or blurring of vision in one or both eyes
- Sudden severe imbalance, giddiness or difficulty walking
- Sudden very severe headache, particularly with vomiting or neck stiffness
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Any of the above symptoms, even if they last only a few minutes and then disappear — call 108 at once
- Note the exact time symptoms started; the treatment clock runs from that moment
- Do not wait for symptoms to improve, do not give food or water, and do not attempt home remedies
- A transient episode that resolves is a warning of a major stroke soon and needs same-day assessment
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Urgent CT scan of the brain to distinguish a clot from a bleed
- Blood sugar, which can mimic stroke when very low
- ECG and echocardiography to look for a cardiac source of clot
- Carotid Doppler to assess neck arteries
- Blood count, clotting profile, kidney function and lipid profile
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Clot-dissolving therapy when the patient arrives within the treatment window and the scan permits
- Admission to a monitored bed for blood pressure, sugar, swallowing and airway management
- Surgical intervention by neurosurgery for selected bleeds and for dangerous brain swelling
- Medication to prevent a second stroke, with strict control of blood pressure, sugar and cholesterol
- Physiotherapy, speech therapy and occupational therapy started early and continued at home
This page is general information, not a diagnosis
Stroke can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Neurology department. If a symptom is sudden or severe, call 9281862028.
