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Do You Know You're Having a Stroke? Mayo ER Doctors Explain What We Need to Know

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By Mayo Clinic, Rochester • • November 25, 2008

A Mayo Clinic study shows a majority of stroke patients don't think they're having a stroke - and as a result - delay seeking treatment until their condition worsens. The findings appear in the November issue of Emergency Medicine Journal.*

Researchers studied 400 patients who were diagnosed at Mayo Clinic's emergency department with either acute ischemic stroke or a transient ischemic attack (TIA), a temporary interruption of blood flow to part of the brain.

Less than half of the patients - 42 percent - thought they were having a stroke.

In fact, most in the study did not go to the emergency room when symptoms appeared. The median time from onset of symptoms to arrival at the hospital was over three and a half hours. Most said they thought the symptoms would simply go away. The delay in seeking medical help was the same among men and women.

When asked how they knew about stroke symptoms, nearly one-fifth said they thought a stroke always came on gradually. Just over half (51.9 percent) said they thought that seeking medical care immediately was important.

Significance of the findings

"Time is crucial in treating stroke," says Latha Stead, MD, emergency medicine specialist and lead author of the study. "Each individual's medical background differs and affects recovery, but in general the sooner a patient experiencing a stroke reaches emergency care, the more likely the stroke can be limited and the condition managed to prevent further damage and improve recovery." The researchers say their findings clearly indicate that better public understanding of stroke symptoms will lead to a faster response and better outcomes.

What you should know

Strokes can happen quickly or can occur over several hours, with the condition continually worsening. The thrombus or clot that is causing the stroke can frequently be dissolved or disintegrated so blood can again flow to the brain. In such cases, immediate treatment can mean the difference between a slight injury and a major disability.

Interestingly only 20.8 percent of the participants knew about such treatment.

By use of stents, medications and other technology, physicians can stop a stroke from spreading and greatly limit damage.

Stroke symptoms include:

• Sudden numbness, weakness, or paralysis of your face, arm or leg - usually on one side of the body

• Sudden difficulty speaking or understanding speech (aphasia)

• Sudden blurred, double or decreased vision

• Sudden dizziness, loss of balance or loss of coordination

• A sudden, severe "bolt out of the blue" headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between your eyes, vomiting or altered consciousness

• Confusion or problems with memory, spatial orientation or perception.

In such cases, a stroke gives no warning.

The Transient Ischemic Attack (TIA)

But one possible sign of an impending stroke is a TIA [temporary interruption of blood flow to part of the brain].

• The signs and symptoms of TIA are the same as for a stroke, but they last for a shorter period - several minutes to a few hours - and then disappear, without leaving apparent permanent effects.

• You may have more than one TIA, and the signs and symptoms may be similar or different.

• A TIA indicates a serious risk that a full-blown stroke may follow.
* See “Knowledge of signs, treatment and need for urgent management in patients presenting with an acute ischaemic stroke or transient ischaemic attack: A prospective study,” Emergency Medicine Journal, Nov 2008, pp. 735-739. Dr. LG Stead, et al., Departments of Emergency Medicine and Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. [E-mail:]

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Article Comments Post a Comment

Stroke Symptoms in ME/CFS
Posted by: findmind
Nov 29, 2008
When my ME/CFS causes me to have severe cognitive problems and inability to speak or understand questions or loved ones names, I usually also get hypothermia and have to get under blankets for a few hours, and it all passes. My MRIs taken for other reasons show white lesion or "spikes" and the drs say they don't know what they mean, so tell me it's normal. How the heck will I be able to tell the difference between them and a stroke? Only if I have one-sided weakness or acute headache? Going to the ER is a real pain because the symptoms are so familiar, and I always think they will pass and I'll be fine. The ER will get real jaded about me if I go every time it happens, and I don't think they will care very much. Are stroke brain clots easily seen? Or are there other tests given? thanks, findmind
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