Know the Warning Signs of Stroke

If you notice one or more of these signs in another person or yourself, don't wait. Call your emergency medical services, and get the person to a hospital right away! Call 911 if you see or have any of these symptoms. Treatment can be more effective if given quickly. Every second counts!

- Sudden numbness or weakness of face, arm, or leg, especially on one side of the body.

- Sudden confusion, trouble speaking or 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.

Not all of these signs occur in every attack. Sometimes they go away and return. If some occur, get help fast.

What is a TIA or transient ischemic attack?

Any of the above signs may be only temporary and last only a few minutes. This might be due to a "little stroke" or "ministroke" called a transient attack or TIA. About 10% of strokes are preceded by TIAs. However, of those who have had one or more TIAs, about 36% will later have a stroke. A person who has had one or more TIAs is 9.5 times more likely to have a stroke that someone of the same age and sex who has not. TIAs are extremely important stroke warning signs. Don't ignore them! Call 911 — GET MEDICAL HELP IMMEDIATELY.

Chain of survival

Every stroke or TIA must be treated as a life-threatening emergency. Timing is very important. A stroke in progress must be diagnosed. If you are going to receive t-PA, a clot-busting drug treatment, or other appropriate therapy, you must get to a hospital quickly so that a doctor can diagnose your stroke and treat you within three hours of the onset of symptoms. In the hospital emergency room, tests will be ordered to determine if a TIA, stroke, or another medical problem caused your symptoms. Treatment for stroke will be different if an artery is blocked (ischemic stroke) or a blood vessel ruptures (hemorrhagic stroke). To increase your chances of surviving a stroke, take these five steps in the Stroke Chain of Survival within three hours of the onset of symptoms:

- Rapid recognition of stroke signs and symptoms: Recognize the symptoms and note when they first occur.

- Rapid activation of the emergency medical services (EMS): Call 911 immediately. Tell them that you have stroke warning signs.

- Rapid EMS transport and hospital pre-notification: Get to the hospital quickly via EMS; they will notify the emergency room (ER).

- Rapid start of pre-hospital care during EMS transport: Receive early assessments and care on the way to the hospital via EMS.

- Rapid diagnosis and treatment at the receiving hospital: Receive prompt evaluation of the medical data and treatment to restore blood flow to the brain or other treatments as appropriate at the ER.

Source: Reproduced with permission. © American Heart Association. World Wide Web site:, 1999.

What are the Risk Factors of Stroke?

The American Stroke Association has identified several factors that increase the risk of stroke. The more risk factors a person has, the greater the chance that he or she will have a stroke. Some of these you can't control, such as increasing age, family health history, race, and gender. But you can change, treat, or modify most risk factors to lower your risk. Factors resulting from lifestyle or environment can be modified with a health care provider's help.

Increasing age

The chance of having a stroke more than doubles for each decade of life after age 55. While stroke is common among the elderly, substantial numbers of people under 65 also have strokes.

Male gender

Overall, men have about a 19% greater chance of having a stroke than women. Among people under age 65, the risk for men is even greater when compared to that of women.

Heredity (family history) and race
The chance of stroke is greater in people who have a family history of stroke. African-Americans have a much higher risk of death and disability from a stroke than whites, in part, because blacks have a greater incidence of high blood pressure, a major stroke risk factor.

Prior stroke

The risk of stroke for someone who has already had one is many times that of a person who has not.

High blood pressure

High blood pressure is the most important risk factor for stroke. In fact, stroke risk varies directly with blood pressure. Many people believe the effective treatment of high blood pressure is a key reason for the accelerated decline in the death rates for stroke.

Cigarette smoking

In recent years, studies have shown cigarette smoking to be an important risk factor for stroke. The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways. The use of oral contraceptives combined with cigarette smoking greatly increases stroke risk.

Diabetes mellitus

Diabetes is an independent risk factor for stroke and is strongly correlated with high blood pressure. While diabetes is treatable, having it increases a person's risk of stroke. People with diabetes often also have high cholesterol and are overweight, which increases their risk even more.

Carotid artery disease

The carotid arteries in your neck supply blood to your brain. A carotid artery damaged by atherosclerosis (a fatty buildup of plaque in the artery wall) may become blocked by a blood clot, which may result in a stroke. If you have a diseased carotid artery, your health care provider may hear an abnormal sound in your neck called a bruit when listening with a stethoscope.

Heart disease

A diseased heart increases the risk of stroke. In fact, people with heart problems have more than twice the risk of stroke as those with hearts that work normally. Atrial fibrillation (the rapid, uncoordinated beating of the heart's upper chambers), in particular, raises the risk for stroke. Heart attack is also the major cause of death among survivors of stroke.

Transient ischemic attacks (TIAs)

TIAs are "ministrokes" that produce stroke-like symptoms but no lasting damage. They are strong predictors of stroke. A person who's had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn't.

High red blood cell count

A moderate or marked increase in the red blood cell count is a risk factor for stroke. The reason is that more red blood cells thicken the blood and make clots more likely.

Source: Reproduced with permission. © American Heart Association. World Wide Web site:, 1999.