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How to spot a stroke

April 30, 2014

When you or a loved one is displaying the ominous symptoms of a stroke, recognizing the warning signs and taking quick action are the keys to survival and recovery.

There are two main stroke types: ischemic strokes, which result from a blood vessel blockage, and hemorrhagic strokes, which are caused by the rupture of a blood vessel in the brain.

Both types of stroke come with five warning signs, all of which come on swiftly:

  • Sudden, intense “thunderclap” headache
  • Sudden loss of vision
  • Sudden loss of ability to speak
  • Sudden loss of balance
  • Sudden loss of sensation of motor skills in one side of the body

Often, these symptoms will pass within a couple of minutes.

"This should not reassure you," says UCI Health neurologist and neuroendovascular surgeon Dr. Radoslav Raychev. "That is what we call the TIA - transient ischemic attack. It is a warning that something big is about to happen."

TIAs are often a precursor to a full-fledged stroke, so they should not be taken lightly. According to the American Heart Association, one-third of all people who suffer a TIA will go on to have a stroke within the year.

Although the majority of sufferers survive their strokes, many will have long-term disability as a result. Getting help as quickly as possible can help improve your chance of surviving and making a full physical recovery.

Getting the right help

After a TIA, it's not only important to get help; stroke sufferers also need the right kind of help.

"Mother Nature is telling you that something is going on. Don't ignore it," Raychev urges.

If you a suffering a stroke, call 911, he advises. Paramedics in Orange County are trained to take stroke patients directly to a stroke receiving center, staffed with highly trained stroke specialists around the clock.

Stroke sufferers may also be taken to a comprehensive stroke center, such as the one at UCI Health.

A comprehensive stroke center is one that has the staff and equipment to offer the most advanced treatment for stroke, such as minimally invasive catheter-based clot retrieval and aneurysm coiling, microsurgical intervention and state-of-the-art neurovascular and neurocritical care 24 hours a day, seven days a week.

UCI Health is home to the first comprehensive stroke center in Orange County.

Raychev says stroke patients should never go directly to the emergency room. If the hospital is not equipped with a stroke care team, patients could lose precious moments being transferred to a hospital that does have the necessary level of care.

Although help should always be sought immediately, some patients may not recognize their symptoms as anything serious right away. If that happens, Raychev cautions patients to go to their doctor for an evaluation as quickly as possible. Second strokes after the initial warning are very common, even if you feel that you have gotten better.

Preventing strokes

Although strokes are extremely serious and have the potential to be devastating, Raychev points out a silver lining: strokes are preventable and treatable with simple lifestyle changes.

The main risk factors for stroke are:

  • High blood pressure. Hypertension is the No. 1 cause of all strokes, making controlling it essential. Raychev notes that well-controlled blood pressure can reduce the incidence of strokes fourfold.
  • Smoking. Smoking contributes to stroke risk by raising blood pressure. “Your risk of stroke decreases substantially when you quit smoking,” Raychev says.
  • Unhealthy lifestyle. A lack of exercise and too much fatty, high-cholesterol and otherwise unhealthy food can contribute to higher blood pressure, increasing your stroke risk.
  • Atrial fibrillation. This is a common type of abnormal heartbeat. Several conditions and lifestyle behaviors can contribute to it, including high blood pressure, heart failure, alcohol use, heart valve disease, coronary artery disease and thyroid abnormalities. The stroke risk due to atrial fibrillate can be as high as 15 percent and can be reduced significantly by taking blood thinners.
  • Genetics. All stroke types have a genetic component. If a close family member has had a stroke or if there is a family history of hypertension, your risk for stroke is higher.

Although lifestyle modifications can lower the risk of ischemic (blockage) stroke, a genetic link is stronger with hemorrhagic (bleeding) strokes.

Raychev suggests patients see their primary care physicians routinely for screening and close monitoring of their stroke risk factors.

“Patients should be aware and pay close attention to both their lifestyle and their family history.”


— Heather Shannon, UCI Health Marketing & Communications