Neurosurgery and Brain Health Identifying the Signs of Stroke By Neurosurgery, May 24, 2016 Known as a “brain attack,” stroke is the leading cause of disability in Americans and a major cause of death. While strokes often occur without warning, certain signs and symptoms can accompany the condition. That’s important, because the sooner you can identify the tell-tale signs of stroke, the sooner you can receive treatment — which is critical for stroke recovery. Types of Stroke There are two major types of stroke: ischemic and hemorrhagic. An ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. The clot can form in an already narrow artery (thrombotic stroke) or travel to a narrow artery in the brain from another blood vessel in the brain or body (cerebral embolism or embolic stroke). Ischemic strokes are by far the most common type of stroke, accounting for about 87 percent of all cases. A hemorrhagic stroke occurs when a blood vessel in the brain becomes weak and bursts open, causing blood to leak into the brain. A transient ischemic attack (TIA) or “mini-stoke” occurs when blood flow to part of the brain stops for a short period of time. TIAs can mimic the symptoms of stroke but usually only last about 24 hours before disappearing. A TIA can be a warning sign for future problems: People who have had a TIA are at a significantly increased risk of having an actual stroke sometime in the near future. Stroke Symptoms and Signs Stroke symptoms typically develop suddenly and without warning. Depending on which parts of the brain were affected by the stroke, they may be severe and fade, start mild and worsen, or occur off and on. They can include: Difficulty speaking or understanding speech Numbness, weakness, or paralysis in your face, arm, or leg, usually on one side of the body Blurred or double vision Sudden, severe headache Difficulty with walking, balance, or coordination The best way to remember these symptoms or identify them in others is with the acronym “FAST:” FACE: Does one side of the face droop when they smile? ARMS: Does one arm drift downward when they raise both arms? SPEECH: Is their speech slurred or in some way peculiar when they talk? TIME: Call 911 immediately if you notice any of these symptoms. Stroke Treatment It’s critical to take quick action if you think you or someone you know is having a stroke, because tissue plasminogen activator (tPA) — the gold standard of treatment for dissolving the clot associated with ischemic stroke — must be administered within four-and-a-half hours to be most effective. Treatment for hemorrhagic stroke usually includes endovascular procedures and surgery. Learn more about stroke prevention and treatment. Visit the UPMC Stroke Institute webpage.