A stroke happens when blood flow to part of the brain is blocked or a blood vessel in the brain bursts. Brain cells begin to die within minutes, so recognizing the signs and getting emergency care fast can mean the difference between full recovery, lasting disability or death. The easiest way to remember the warning signs is BE FAST.
The BE FAST warning signs
- B – Balance: sudden loss of balance, dizziness or trouble walking
- E – Eyes: sudden loss of vision or blurred or double vision in one or both eyes
- F – Face: one side of the face droops or feels numb; ask the person to smile
- A – Arm: weakness or numbness in one arm or leg; ask them to raise both arms and see if one drifts down
- S – Speech: slurred speech, difficulty speaking or understanding, or confusion
- T – Time: time to call 911 immediately
Other sudden symptoms can include a severe headache with no known cause, especially with vomiting, and sudden confusion.
Note the time when symptoms first started or when the person was last seen well. This information guides which treatments doctors can use.
Types of stroke
Ischemic stroke
This is the most common type. A blood clot or narrowed artery blocks blood flow to part of the brain.
Hemorrhagic stroke
A blood vessel in or around the brain bursts and bleeds. High blood pressure and aneurysms are common causes.
Transient ischemic attack (TIA)
Often called a “mini-stroke,” a TIA causes stroke symptoms that go away, usually within minutes to an hour. A TIA is a warning sign: the risk of a full stroke is highest in the days and weeks that follow. Anyone with TIA symptoms needs emergency evaluation, even if they feel fine afterwards.
Why every minute matters
During a typical untreated ischemic stroke, millions of brain cells are lost every minute. Treatments that restore blood flow work best when given early.
- Clot-dissolving medicine (such as alteplase or tenecteplase) can be given through a vein to eligible patients, generally within 4.5 hours of when symptoms started or the person was last known well.
- Mechanical thrombectomy, in which a specialist removes the clot using a catheter threaded through an artery, can help people with blockages in large brain arteries. It is most effective when done early, but for selected patients it may be performed up to 24 hours after symptoms began.
Hemorrhagic strokes are treated differently, for example by controlling blood pressure, reversing blood thinners and sometimes surgery.
Keep reading
The rest of this guide is free. Watch a short ad to unlock it and support independent health writing.
Preparing your ad…
What to do if you suspect a stroke
- Call 911 right away. Do not drive the person yourself; paramedics can begin assessment and take them to a hospital equipped to treat stroke.
- Note the time symptoms started.
- Do not give food, drink or medicine, including aspirin, because swallowing may be affected and aspirin can worsen a bleeding stroke.
- Keep the person safe and comfortable. If they are unresponsive but breathing, place them on their side.
- If they stop breathing normally, start CPR.
Risk factors
Risk factors you can manage
- High blood pressure, the single most important risk factor
- Smoking
- Diabetes
- High cholesterol
- Atrial fibrillation, an irregular heart rhythm that can cause clots
- Physical inactivity and excess weight
- Heavy alcohol use
- Obstructive sleep apnea
Risk factors you cannot change
- Older age
- Family history of stroke
- A previous stroke or TIA
- Sex: women have more strokes over their lifetime, partly because they live longer; pregnancy and some hormone therapies also affect risk
- Race and ethnicity: Black, Hispanic and some Asian American populations have higher rates of stroke in the United States
How to lower your risk of stroke
- Control blood pressure. Check it regularly and take prescribed medicines.
- Stop smoking. Risk begins to fall soon after quitting.
- Manage diabetes and cholesterol.
- Treat atrial fibrillation. If you have AFib, ask your clinician whether you need a blood thinner.
- Stay active. Aim for at least 150 minutes of moderate activity a week.
- Eat a heart-healthy diet rich in vegetables, fruit, whole grains and fish, with less salt.
- Limit alcohol.
Life after a stroke
Recovery depends on the size and location of the stroke and how quickly treatment started. Many people improve most in the first few months, and progress can continue for longer. Rehabilitation may include physical therapy, occupational therapy and speech therapy. Emotional changes, including depression, are common after stroke and treatable.
The CDC and the American Stroke Association have more on stroke warning signs.
Frequently asked questions
Can stroke symptoms go away on their own?
Yes, in a TIA. But you cannot tell at home whether symptoms are a TIA or the start of a major stroke, so always call 911.
Can young people have a stroke?
Yes. Although risk rises with age, strokes can occur at any age, including in children and young adults.
What is the difference between a stroke and a heart attack?
A stroke affects blood flow to the brain; a heart attack affects blood flow to the heart muscle. Both are emergencies.
The bottom line
Remember BE FAST: balance, eyes, face, arm, speech, time. If you notice any of these signs, call 911 immediately and note the time. Fast treatment can save brain function and lives.
This article is for general information and is not a substitute for advice from a qualified healthcare professional.