Stroke Warning Signs: Act FAST

Stroke is the second leading cause of death and the leading cause of adult disability worldwide. Approximately 1.9 million neurons die every minute during a stroke — making rapid recognition and emergency response absolutely critical. The window for effective treatment is narrow: 4.5 hours for thrombolysis, 24 hours for thrombectomy in selected patients.

The FAST acronym remains the most important public health message: Face drooping (ask the person to smile — is one side drooping?), Arm weakness (ask them to raise both arms — does one drift down?), Speech difficulty (is speech slurred, strange, or absent?), Time to call emergency services immediately if any of these are present.

Less well-known stroke symptoms include: sudden severe headache with no known cause (thunderclap headache — may indicate hemorrhagic stroke), sudden vision loss or double vision in one or both eyes, sudden severe dizziness or loss of balance, sudden confusion or difficulty understanding speech, and sudden numbness or weakness of face, arm, or leg especially on one side.

Transient ischemic attacks (TIAs or 'mini-strokes') cause the same symptoms but resolve within 24 hours. They are a major warning sign of impending full stroke — up to 10% of patients have a major stroke within 48 hours of a TIA. Any TIA requires same-day emergency evaluation, not 'wait and see'.

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