Written and medically reviewed by Dorcas Morak, Pharm.D
October 29 is World Stroke Day, a global observance dedicated to raising awareness about stroke prevention, recognition, and treatment. Stroke remains one of the leading causes of death and long-term disability, but recognizing the warning signs and seeking emergency care immediately can significantly improve outcomes. Acting quickly may be the difference between a full recovery and permanent disability.
What Happens During a Stroke?
A stroke occurs when blood flow to part of the brain is interrupted, either because a blood clot blocks an artery (ischemic stroke) or a blood vessel bursts (hemorrhagic stroke). Without oxygen and nutrients, brain cells begin dying within minutes, making rapid treatment essential.
Approximately 87% of strokes are ischemic, making them the most common type. Although hemorrhagic strokes are less common, they are often more severe and require different treatment approaches.
What Does the FAST (or BE FAST) Acronym Mean?
FAST is a simple way to recognize the most common warning signs of a stroke:
- F – Face drooping: One side of the face droops or feels numb.
- A – Arm weakness: One arm becomes weak or numb.
- S – Speech difficulty: Speech may become slurred or difficult to understand.
- T – Time to call 911: Call emergency services immediately if any of these symptoms occur.
Many healthcare organizations now promote BE FAST, which adds two additional warning signs:
- B – Balance: Sudden loss of balance or coordination.
- E – Eyes: Sudden vision loss or trouble seeing in one or both eyes.
Recognizing these symptoms quickly can help people receive lifesaving treatment sooner.
What Other Symptoms Can Signal a Stroke?
Not every stroke presents the same way. Other warning signs include:
- Sudden confusion
- Sudden dizziness
- Severe headache with no known cause
- Numbness or weakness affecting one side of the body
Stroke symptoms usually begin suddenly rather than developing gradually. Even if symptoms disappear after a few minutes, call 911 immediately. Temporary symptoms may be caused by a transient ischemic attack (TIA), which can be an early warning sign of a major stroke.
Why Every Minute Matters During a Stroke
Brain cells die at an estimated rate of nearly 1.9 million neurons per minute during an untreated ischemic stroke. The sooner treatment begins, the greater the chance of preserving brain function, reducing disability, and improving recovery.
This is why healthcare professionals encourage people to seek emergency care immediately rather than waiting to see if symptoms improve.
What Should You Do If You Suspect a Stroke?
If you think someone is having a stroke:
- Call 911 immediately.
- Note the time symptoms first began, if known.
- Keep the person safe and comfortable while waiting for emergency responders.
- Do not drive yourself or someone else to the hospital unless emergency services are unavailable. Paramedics can begin treatment and notify the hospital before arrival.
- Do not give the person food, drinks, or medications—including aspirin—unless instructed by emergency medical personnel, since some strokes are caused by bleeding.
What Is a Transient Ischemic Attack (TIA)?
A transient ischemic attack (TIA), often called a "mini-stroke," causes temporary stroke symptoms that usually resolve within minutes or hours. Although symptoms improve, a TIA is a medical emergency because it significantly increases the risk of a full stroke, especially within the next few days.
Anyone who experiences TIA symptoms should seek immediate medical evaluation, even if they feel completely normal afterward.
How Is a Stroke Treated in the Emergency Room?
Treatment depends on the type of stroke. For eligible ischemic strokes, doctors may administer an intravenous clot-dissolving medication such as alteplase (Activase®) or tenecteplase (TNKase®) if treatment begins within the appropriate time window.
Some patients may also undergo mechanical thrombectomy, a minimally invasive procedure that removes a large blood clot from an artery in the brain and restores blood flow.
How Are Ischemic and Hemorrhagic Strokes Treated Differently?
Because ischemic and hemorrhagic strokes have different causes, they require different treatments.
Ischemic strokes are caused by blood clots and are treated by restoring blood flow using clot-dissolving medications or mechanical thrombectomy when appropriate.
Hemorrhagic strokes occur when a blood vessel ruptures and causes bleeding in the brain. Treatment may include medications to control blood pressure, reverse blood-thinning medications when appropriate, reduce pressure inside the skull, or surgery to repair the bleeding blood vessel or relieve pressure.
What Medications Help Prevent Another Stroke?
After a stroke, doctors prescribe medications based on the underlying cause and each patient's risk factors. Common medications include:
- Antiplatelet medications: aspirin or clopidogrel (Plavix®)
- Anticoagulants: apixaban (Eliquis®), rivaroxaban (Xarelto®), dabigatran (Pradaxa®), or warfarin for people with atrial fibrillation or other clotting disorders
- Blood pressure medications: lisinopril, losartan, amlodipine, or hydrochlorothiazide
- Cholesterol-lowering medications: atorvastatin (Lipitor®) or rosuvastatin (Crestor®)
Taking these medications exactly as prescribed, along with managing other health conditions, is one of the most effective ways to reduce the risk of another stroke.
Who Is Most at Risk for Stroke?
Several factors increase stroke risk, including:
- High blood pressure
- Diabetes
- Atrial fibrillation
- High cholesterol
- Smoking
- Obesity
- Physical inactivity
Some risk factors, such as older age, family history, and a previous stroke or TIA, cannot be changed. However, controlling blood pressure, managing diabetes and cholesterol, quitting smoking, staying physically active, and taking prescribed medications consistently can significantly lower your risk.
How the RxLess® Assurance Plan Can Help Lower Medication Costs
Many medications used to help prevent future strokes may need to be taken long term. Comparing prescription prices before filling medications such as clopidogrel, atorvastatin, rosuvastatin, lisinopril, losartan, or amlodipine may help reduce out-of-pocket costs.
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