Symptoms of Stroke - 24 Hours

The signs and symptoms of a stroke often develop quickly. However, they can develop over hours or even days, such as when a transient ischemic attack (TIA) turns into a stroke.

The type of symptoms depends on the type of stroke and the area of the brain that is affected.

Signs and symptoms of a TIA or stroke may include:

• Sudden numbness or weakness, especially on one side of the body
• Sudden confusion or trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, or loss of balance or coordination
• Sudden severe headache with no known cause

The FAST test can help you remember what to do if you think someone may be having a stroke:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T—Time: If you observe any of these signs, call 9-1-1 right away. Early treatment is essential.

If you think you or someone else is having a TIA or stroke, don’t drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts.

Sourced from NIH

Causes of Stroke - 24 Hours

There are two main types of stroke that have different causes. Ischemic strokes are caused by a blockage of a blood vessel. Hemorrhagic strokes, which are not considered on this 24 Hours page, are caused by sudden bleeding in the brain. Sometimes the doctor may not be able to figure out the cause of your stroke.

Ischemic stroke

Ischemic strokes are usually caused by a piece of plaque or a blood clot that blocks blood flow to the brain.

Plaque buildup

When a fatty substance called plaque builds up on the inner walls of the arteries, it can lead to a disease called atherosclerosis. Plaque hardens and narrows the arteries, which limits blood flow to tissues and organs.

Plaque can build up in any artery in the body, including arteries in the brain and neck. Carotid artery disease is when plaque builds up in the carotid arteries in the neck that supply blood to the brain. It is a common cause of ischemic stroke.

Blood clots in the brain or elsewhere in the body

Plaque in an artery can break open. Blood platelets stick to the site of the plaque injury and clump together to form blood clots. These clots can partly or fully block an artery.
A blood clot that forms in one part of the body can also break loose and travel to the brain. This type of ischemic stroke is called an embolic stroke. Certain heart and blood conditions, such as atrial fibrillation and sickle cell disease, can cause blood clots that lead to stroke.

Inflammation

Chronic (long-term) inflammation contributes to ischemic stroke. Researchers are still trying to understand this fully. We know that inflammation can damage the blood vessels and contribute to atherosclerosis, however. In addition, ischemic stroke can lead to inflammation that further damages brain cells. 

Sourced from NIH

Diagnosis of Stroke - 24 Hours

Your doctor will diagnose a stroke based on your signs and symptoms, your medical history, a physical exam, and test results. Your doctor will want to find out the type of stroke you’ve had, its cause, the part of the brain that is affected, and whether you have bleeding in the brain. If your doctor thinks you’ve had a transient ischemic attack (TIA), he or she will look for its cause to help prevent a future stroke.

Medical history and physical exam

Your doctor will ask you or a family member about your risk factors for stroke. Tell your doctor if you or someone in your family has had a stroke. Your doctor will also ask about your signs and symptoms and when they began.

During the physical exam, your doctor will check you for:

• Confusion
• Coordination and balance
• Mental alertness
• Numbness or weakness in your face, arms, and legs
• Trouble speaking or seeing clearly

The exam will help your doctor determine how severe your stroke was and plan your treatment.

Your doctor will look for signs of carotid artery disease, a common cause of ischemic stroke. He or she will listen to your carotid arteries with a stethoscope. A whooshing sound called a bruit may suggest changed or reduced blood flow due to plaque buildup in the carotid arteries.

Diagnostic tests and procedures

Your doctor will order tests to help rule out other health problems with similar signs or symptoms.

Your doctor will order an imaging test to look at the blood vessels in your brain. This will help determine what type of stroke you have and where exactly it happened. The quicker these tests can be done, the better your doctor can treat you. Tests to diagnose stroke include the following:

• Computed tomography (CT) uses X-rays to take clear, detailed pictures of your brain. It is often done right after a stroke is suspected. A brain CT scan can show if there is bleeding in the brain or damage to the brain cells from a stroke.
• Magnetic resonance imaging (MRI) uses magnets and radio waves to create pictures of your brain. An MRI may be used instead of—or in addition to—a CT scan to diagnose a stroke. This test can detect changes in brain tissue and damage to brain cells.
• Other imaging tests to look for narrowed blood vessels in the neck or an aneurysm or tangled blood vessels in the brain.

Your doctor may also order the following blood or heart tests.

• Blood tests. Your doctor may test the blood and platelet count and glucose (sugar) levels in your blood to make sure they are stable and to see if a certain medicine can treat your stroke. Your doctor may also do blood tests to see how well your blood is clotting and to look for muscle damage.
• Electrocardiogram (EKG). An EKG can help detect heart problems that may have led to a stroke. For example, this test can help diagnose atrial fibrillation or a previous heart attack.
• Lumbar puncture (also called a spinal tap), if the imaging scan does not detect any bleeding in the brain but your doctor still thinks you may have had a hemorrhagic stroke. The doctor will use a needle to collect fluid from around your spine. The fluid will be tested for substances from broken-down blood cells.

Sourced from NIH

Summary of Stroke – First 24 Hours

The signs and symptoms of a stroke often develop quickly but can take hours or even days. The FAST test can help you remember what to do if you think 
someone may be having a stroke:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T—Time: If you observe any of these signs, call 9-1-1 right away. Early treatment is essential.

If you think you or someone else is having a TIA or stroke, don’t drive to the hospital or let someone else drive you. Call an ambulance so that medical 
personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts.

Symptoms: Symptoms include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause.

Causes: There are two main types of stroke, each with a different cause. Ischemic strokes are caused by a blockage of a blood vessel. Hemorrhagic 
strokes, which are not considered on this page, are caused by sudden bleeding in the brain. Sometimes the doctor may not be able to figure out the cause of your stroke.

Diagnosis: Your doctor will diagnose a stroke based on your signs and symptoms, your medical history, a physical exam, and test results. Your doctor 
will want to find out the type of stroke you’ve had, its cause, the part of the brain that is affected, and whether you have bleeding in the brain. If your doctor thinks you’ve had a transient ischemic attack (TIA), he or she will look for its cause to help prevent a future stroke.

Treatments: The world's leading stroke experts recommend Alteplase (tPA) within 4.5 hours of the onset of an ischemic stroke. Evidence indicates that the earlier the treatment, the better the outcome including the ability to walk independently and to return home. After administration of tPA, medical 
thrombectomy is recommended for qualifying patients whose strokes are due to a large artery occlusion in the anterior circulation that are treated within 24 hours of the stroke onset.