Stroke can happen to anyone, at any age and at any time. The number of strokes among younger adults under 55 is rising worldwide, and every day in the UK around 240 people experience the traumatic and life-changing effects of a stroke.
Author
- Siobhan Mclernon
Senior Lecturer, Adult Nursing and co-lead, Ageing, Acute and Long Term Conditions. Member of Health and Well Being Research Center, London South Bank University
A stroke is sometimes described by doctors and stroke awareness campaigns as a "brain attack" to help people understand that a stroke is as urgent and life-threatening as a heart attack . Both happen when blood flow is suddenly cut off, depriving vital tissue of oxygen and nutrients.
There are two main types of stroke. In an ischaemic stroke, blood flow to the brain is blocked, usually by a clot in a blood vessel. Without oxygen, brain cells begin to die, which can cause loss of movement, speech, memory or even death. In a haemorrhagic stroke, a blood vessel inside the brain bursts. This is often due to high blood pressure , which weakens blood vessel walls and makes them more likely to rupture.
Treating a stroke is a race against time because, as doctors say, " time is brain ": the longer the brain is starved of blood and oxygen, the more brain cells die. Treatments that can dissolve or remove a clot in an ischaemic stroke or lower dangerously high blood pressure in a haemorrhagic stroke must be given quickly to limit brain damage.
Anyone with a suspected stroke should be taken by emergency services directly to a specialist stroke unit. Patients admitted to these dedicated units tend to have better outcomes because they receive expert care from doctors trained specifically to manage stroke.
How to recognise the signs of stroke
A lack of early recognition of stroke symptoms is linked to higher mortality rates. The acronym "Fast" (Face, Arm, Speech, Time) has been a cornerstone of public stroke awareness for more than 20 years. It was developed as a quick screening tool for use before hospital admission, helping people recognise the signs of a stroke and seek urgent medical help.
Fast highlights the most common warning signs of stroke, but some strokes present differently. To make sure fewer cases are missed, additional symptoms such as dizziness, visual changes and loss of balance have been added, creating the Be Fast acronym.
B = Balance problems. A sudden loss of balance or coordination, dizziness, or a sensation that the room is spinning.
E = Eyes. Sudden blurred vision, loss of vision in one or both eyes, double vision, or difficulty focusing.
F = Face. Facial weakness or unevenness, often with a droop on one side of the mouth or eye.
A = Arm or leg weakness or numbness, often affecting one side of the body.
S = Speech difficulty, slurred speech, trouble finding words, or an inability to speak clearly.
T = Time to call an ambulance. Make a note of when symptoms began, as this helps doctors decide which treatment is most effective.
Other warning signs
Stroke symptoms often develop suddenly and can vary from person to person. Some people, particularly women, may experience stroke symptoms that are not included in the Be Fast acronym. Women are less likely to be recognised as having a stroke because their symptoms can differ from men's. These may include sudden fatigue, confusion, nausea, fainting, or general weakness rather than clear paralysis or slurred speech.
Other possible signs for any person include a severe headache with no clear cause, vomiting, difficulty swallowing, agitation, or sudden memory loss. In some cases, a person may collapse, lose consciousness, or have a seizure.
Sometimes stroke symptoms last only a few minutes or hours before disappearing completely within 24 hours. This may indicate a Transient Ischaemic Attack (TIA), sometimes called a "mini stroke." A TIA happens when the blood supply to the brain is briefly interrupted, causing temporary symptoms. The difference between a TIA and a full stroke is that the blockage clears on its own before permanent brain damage occurs. However, a TIA is still a medical emergency and a serious warning sign that a major stroke could soon follow.
Advances in technology
Telemedicine has become an important tool in making rapid diagnosis and early treatment possible. By using secure video links, paramedics can consult with hospital stroke specialists in real time, even while still at the scene or en route to hospital. This allows early diagnosis, faster decision making and immediate preparation for treatment once the patient arrives.
For example, some ambulances now operate as mobile stroke units equipped with brain imaging scanners and clot-busting medicines. In London, video calls between senior doctors and paramedics at emergency scenes have helped speed up care and direct patients to the most appropriate treatment centre.
While telemedicine connects specialists to paramedics on the move, other tools are bringing medical help directly to patients within moments of a 999 call. The GoodSAM app was first developed to improve survival after cardiac arrest by alerting nearby trained responders to begin CPR before an ambulance arrives. The platform has since expanded to support other life-threatening emergencies, including stroke.
When someone calls for help, the system identifies clinically trained staff or volunteers in the area and dispatches them to the scene while paramedics are on their way. These responders can provide rapid assessment, basic first aid and reassurance to the patient and family, and can help ensure that key information such as the time symptoms began is ready for the arriving medical team. By combining digital technology, trained volunteers and rapid communication, the app is helping bridge the critical gap between the onset of symptoms and hospital treatment: the period where, quite literally, every minute matters.
A stroke can strike suddenly and without warning, but quick recognition and immediate medical attention can mean the difference between life and death. Learning the Be Fast signs and acting immediately could save a life, protect the brain and preserve a person's ability to speak, move and think.
Siobhan Mclernon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
