Recognizing Stroke Symptoms: Every Minute Counts

What is a Stroke?¹

A stroke occurs when there is a sudden loss of blood flow to the brain. Strokes are categorized into three main types: Ischemic, Hemorrhagic, and Transient. Although they all are considered to be medical emergencies and have the potential to cause severe disability or death, a hemorrhagic stroke is considered to be the most immediately life-threatening type because it holds the potential for a person to bleed out rapidly. These types of strokes increase pressure in the brain, resulting in a quick decline of the patient.

 

Let’s take a quick look at the three types in a little more detail:

Ischemic

An ischemic stroke happens when a blockage or “clog” occurs in a blood vessel, impeding blood flow to a specific part of the brain. As a result, the brain tissue and cells start to die within minutes from the lack of oxygen and nutrients. These can be caused by clots that form inside a vessel in the brain, or clots that form in a vessel anywhere else in the body, and travel to the brain. 

 

Hemorrhagic

A hemorrhagic stroke happens when a blood vessel in the brain bursts, or ruptures and bleeds. These ruptures can occur deep within the brain or in the subarachnoid space between the brain and the membranes that cover the brain. As mentioned before, in this case, there is an immediate concern for rapid blood loss present, which can quickly become a life-threatening situation.  An aneurysm is a weak or “ballooned” area located on the wall of an artery that should be closely monitored if discovered. These areas present a higher risk of rupture, leading to a stroke.

 

Transient (TIA)

Also called a “mini stroke,” transient strokes are recurring strokes that indicate the likelihood of a future, more serious stroke occurring. TIA’s are small clots that cause temporary blockages or a blockage that reduces blood flow to a specific area of the brain. The main difference between a TIA and a stroke is the level of brain injury that occurs. A TIA generally causes temporary symptoms without permanent brain damage, whereas a stroke typically results in lasting damage. Your job is not necessarily to be able to identify what type of stroke a person might be having, but instead to call for help right away if there is any indication they may be experiencing a CVA (Cerebrovascular Accident) event. Any event like this warrants a medical evaluation promptly. It will be important for them to get to the hospital ASAP so imaging can be performed.

 

B.E. F.A.S.T.²

 

B.E. F.A.S.T. is a mnemonic (or acronym) that is used as a memory tool to help your brain easily remember and quickly recall important information on how to identify if someone is having a stroke. The letters each stand for an identifier that will guide you through an assessment. If a person gets to the hospital within 4.5 hours of the first symptom of an ischemic stroke, they will more likely benefit from a thrombolytic drug therapy that can break up the clot, which will greatly reduce the risk of permanent brain damage and speed up recovery for the patient.

4.5-9 hours is still within a critical timeframe for certain patients who might be eligible for thrombolytic therapy. Different methods of treatment are also available within the 24-hour mark.  The longer a person waits to be evaluated, the more likely irreversible damage will occur. This is why it is critical to get the patient help as soon as possible and keep a close track of the timing of symptoms.

 

You can B.E. F.A.S.T. in identifying a stroke by performing this quick assessment:

B - Balance loss: Ask the person, “Are you feeling dizzy, or having trouble with balance?”

E - Eye or vision: Ask the person, “Are you having trouble seeing or any visual disturbances?

F - Face: Ask the person to smile to see if either side of the mouth droops.

A - Arms: Ask the person to raise both arms in front of them, and check to see if either arm falls down when you ask them to hold that position.

S - Speech: Ask the person to repeat a simple phrase and see if their speech is slow or slurred.

T - Time: If you see any of these signs, call 911 immediately.

 

Signs and Symptoms of a Stroke³

There are many indicators a person might be having a stroke, but it is important to know that not all symptoms may be present in any one person at any given time. And sometimes symptoms differ between biological men and women.

 

The most common universal symptoms you might observe are:

• Numbness or weakness in the face, arm, or leg on one side of the body. Symptoms will typically present on the opposite side of the part of the brain where the stroke is occurring since each side of the brain is responsible for sensation or movement on the opposite side of the body.
• Vision disturbances in one or both of the eyes, which include blurred or double vision and loss of vision in either eye.
• Dizziness, difficulty walking, or loss of balance.
• Confusion and difficulty speaking or understanding when spoken to.
• A sudden and severe headache which is typically associated with a hemorrhagic stroke.

 

 

Women tend to experience these additional symptoms:

• Pain in the face or legs
• Hiccups
• Nausea/Vomiting
• Generalized Weakness
• Chest Pain
• Shortness of Breath
• Rapid Heartbeat (Tachycardia)

 

 

Seeking Help⁴

One of the confusing things about a stroke is that many of the symptoms are similar to various other conditions. Keep in mind that “if you are in doubt, you should have them checked out!”

 

Follow these steps when helping a person:

1. Stay calm. Say to yourself, “This is not my emergency, I am the helper!”

2. Do an assessment using the B.E. F.A.S.T. test. If they meet the criteria, or are symptomatic in even a few of these areas, call 911 right away and tell the dispatcher you suspect a stroke! It is important to say the word “stroke” to indicate urgency.

3. Ask them when the last time they felt normal was and/or when the symptoms started. This information will help the medical team know what the best treatment options will be for this individual.

4. Do not give them any food, water, or medication (including aspirin)

5. Stay with them and reassure them until help arrives. Utilize this time to obtain a current medication list and pertinent medical history to have ready for the EMS workers. Remember that time is critical when it comes to a stroke! Your goal is to work together with other medical staff to get this person to definitive care as soon as possible. Knowing the signs and quickly responding will help minimize the risk of permanent damage or death to these patients, giving them a promising outcome and speedy recovery!

 

 

References:

1. Types of Stroke. (2026). Johns Hopkins Medicine. Retrieved August 4, 2026, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/types-of-stroke

 

2. Signs and Symptoms of Stroke. (2026). Retrieved August 4, 2026, from https://www.cdc.gov/stroke/signs-symptoms/index.html

 

3. Symptoms. (n.d.-b). SCAI - Seconds Count. Retrieved August 4, 2026, from https://www.secondscount.org/condition/stroke/symptoms

 

4. Use this checklist to BE FAST if stroke symptoms strike. (n.d.). Retrieved August 4, 2026, from https://www.medstarhealth.org/blog/stroke-symptoms-checklist