What are the signs and symptoms of a stroke?
F.A.S.T. is an easy way to remember the sudden signs of stroke:
- Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
- Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?
- Time to call 9-1-1 – If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared.
Beyond F.A.S.T. – Other Symptoms You Should Know
- Sudden numbness or weakness of the leg, arm or face
- Sudden confusion or trouble understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
If someone if having a stroke should I drive them to the hospital or call 911?
ALWAYS call 911. EMS will provide medical care upon their arrival and can monitor vital signs during transport. In route, EMS will notify the receiving hospital of a “code stroke.” This allows the hospital’s emergency department and medical professionals to prepare for the patient’s arrival. During a brain attack, approximately 1.9 million brain cells die every minute. Every minute is vital to a patient suffering a brain attack.
What if I am not sure if it is a stroke?
Even if you are unsure it is a stroke, call 911 and lie down until EMS arrives. A brain attack is a time sensitive disease and it’s better to be cautious, than to risk not receiving timely and appropriate care.
When the ambulance arrives, what do I tell them?
When EMS arrives, they will want to know when the patient was last seen normal. This is very important information and will determine the care path for the patient. If the time of last known normal is undetermined, consider checking the last time they utilized their cell phone or sent an email.
They will also ask you pertinent medical questions which include past medical history, current medications, allergies, physician's name and hospital choice. Specific questions may include when the patient ate last, when and what medications were last administered, and if unusual stressors have been present (e.g., infections, stress, exercise).
Family members can help EMS by compiling a list or gathering all of the patient's information and medications. Keep a current list of medications (include the medication name, dose and administration frequency) and a complete past medical history. This will help ensure the necessary patient information is relayed to medical providers.
What is the difference between a Primary and Comprehensive Stroke Center?
A Primary Stroke Center has 24/7 neurology coverage, can administer IV-tPA, follows acute code stroke protocols, has transfer protocol in place if interventional care is needed, and is also able to provide patients access to stroke rehab. In addition, they are required to provide stroke education to EMS, the community, and to patients upon discharge. It is also required they participate in basic research.
A Comprehensive Stroke Center fulfills all the requirements of a Primary Stroke Center, but is also required to have a Neurointerventionalist, staff trained in neurocritical care, the highest level of diagnostic and procedural technology, and critical care beds.
If you are having a stroke, your physician will determine if you need care at a Primary or Comprehensive Stroke Center.
What is a stroke?
Similar to a heart attack, a stroke or “brain attack” is a disease that affects the blood vessels of the neck and brain. Blood vessels carry oxygen to the brain, which keeps the brain tissue alive. Blockage-type strokes, also called ischemic strokes are a result of a blocked vessel and are the most common form of stroke (87%). When a vessel is blocked, blood cannot reach the tissue and the brain tissue dies. Another type of stroke is bleeding or hemorrhagic strokes. These are caused when the blood vessel ruptures and the tissue dies because it is drowning in blood. Bleeding strokes are less common and represent 13% of all strokes.
What is the difference between a Neurologist, an Interventional Neurologist, an Interventional Neuroradiologist and a Neurosurgeon?
A Neurologist is a physician specializing in general neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists may also be involved in clinical research, and clinical trials, as well as basic research and translational research. While Neurology is a non-surgical specialty, its corresponding surgical specialty is Interventional Neurology, Interventional Neuroradiology and/or Neurosurgery.
An Interventional Neurologist, is a specialist that utilizes minimally invasive, image guided endovascular techniques to diagnose and treat many of the most complex diseases of the brain, neck, and spine. They perform surgery without making a surgical incision. Treatments without surgery are also known as endovascular treatments. The term endovascular means “inside a blood vessel.” This subspecialty cares for the patient in the emergency room, they perform the diagnostics and treatments and follow the patient through discharge and ultimately the follow up visit in the clinic.
An Interventional Neuroradiologist is a subspecialty of radiology that utilizes minimally invasive, image guided endovascular techniques to diagnose and treat many of the most complex diseases of the brain, neck, and spine. They perform surgery without making a surgical incision. Treatments without surgery are also known as endovascular treatments. The term endovascular means “inside a blood vessel.” If you suffer a stroke, the Interventional Radiologist will perform the diagnostics and endovascular therapy (if needed), but will not provide care in the emergency room, while in the hospital, or provide follow up in the clinic.
A Neurosurgeon is a specialist who treats diseases and conditions affecting the nervous system, which includes the brain, the spine and spinal cord, and the peripheral nerves. Neurosurgeons perform brain and spine surgery and are essential for the care of many neurologically ill patients.