Understanding Strokes: What They Are, the Signs, and Why Every Minute Matters

When most people hear the word stroke, they know it's serious.

But would you actually recognize one if it was happening in front of you?

Would you recognize it if the person wasn't unconscious? What if they were still talking? What if they just suddenly seemed confused, couldn't see correctly, or were having trouble keeping their balance?

Knowing the signs of a stroke—and knowing what to do when you see them—can save someone's life. It can also make a huge difference in what that person's life and recovery look like afterward.

So let's start with the basics.

What Is a Stroke?

A stroke happens when blood flow to part of the brain is interrupted.

Your brain needs a constant supply of oxygen-rich blood. When that blood supply is blocked or a blood vessel bursts, brain cells can begin dying within minutes.

There are two main types of stroke:

Ischemic stroke: This happens when a blood vessel supplying the brain becomes blocked, usually by a blood clot or buildup in an artery. This is the most common type of stroke.

Hemorrhagic stroke: This happens when a blood vessel in or around the brain ruptures and causes bleeding.

Although the causes are different, both are medical emergencies.

And you can't look at someone and determine which kind they're having. Medical professionals need to determine that because treatment depends on the type of stroke.

What About a "Mini-Stroke"?

You may have heard someone say they had a "mini-stroke."

The medical term is a Transient Ischemic Attack, or TIA.

A TIA happens when blood flow to the brain is temporarily blocked. The symptoms can look exactly like a stroke but may disappear after a few minutes or hours.

That's part of what makes a TIA dangerous.

Someone may suddenly have slurred speech or weakness and then start feeling better. It's easy to think:

Well, it went away, so I must be okay.

Don't assume that.

A TIA is sometimes called a warning stroke because it can be a warning that a full stroke may happen in the future.

If someone develops stroke symptoms and they disappear, they still need emergency medical attention.

When It's Someone You Love

I want to get personal for a minute.

My stepdad has had TIAs.

And as his daughter, they're terrifying.

I've been on the phone with him when one second we're having a normal conversation, and the next he's slurring his words and forgetting what he's doing.

There's a helplessness that comes with being on the other end of that phone. You know something isn't right. You know he needs help. But you're not physically standing there with him.

Then there's getting to the hospital and only seeing the residual effects of what just happened.

Because that's one of the scary things about a TIA—the symptoms can improve or disappear.

By the time someone gets evaluated, they may seem much more like themselves again. But that doesn't mean what happened wasn't serious.

My stepdad is also stubborn.

He doesn't like going to the doctor, and he's definitely not the person who's excited about being told he needs to go to the hospital.

I love him dearly, but in those moments, whether he wants to go isn't really what matters.

I'd rather have him irritated with me for taking it seriously than wish later that I had pushed harder.

And I think that's something families need to hear.

When it's someone you love, it's easy to second-guess yourself. They might tell you they're fine. They might say it's going away. They might not want an ambulance. You might worry that you're overreacting.

Stroke symptoms disappearing doesn't mean they should be ignored.

I've seen firsthand how quickly things can change.

That's part of why I'm writing this series.

I don't want someone to read the signs of a stroke for the first time while they're sitting in an emergency room wishing they'd known them sooner.

Know the Signs: B.E. F.A.S.T.

One of the easiest ways to remember common stroke symptoms is B.E. F.A.S.T.

B — Balance

Watch for a sudden loss of balance or coordination.

Is the person suddenly dizzy?

Are they stumbling?

Are they having difficulty walking when they normally wouldn't?

E — Eyes

Watch for sudden changes in vision.

That can include blurred vision, double vision, or losing vision in one or both eyes.

F — Face

Ask the person to smile.

Does one side of their face droop?

Does their smile suddenly look uneven?

Is one side of their face numb?

A — Arms

Ask the person to raise both arms.

Does one arm drift downward?

Are they suddenly unable to lift one arm normally?

Is one arm weak or numb?

Stroke symptoms commonly affect one side of the body.

S — Speech

Listen closely to how they're talking.

Is their speech suddenly slurred?

Are their words difficult to understand?

Are they struggling to get words out?

Do they seem unable to understand what you're saying?

You can ask them to repeat a simple sentence and listen for anything unusual.

T — Time to Call 911

If you're noticing these signs, it's time to call 911.

Not in an hour.

Not after they lie down for a while.

Not after you finish what you're doing.

And not only if you're 100% positive it's a stroke.

Call 911.

There Can Be Other Signs, Too

B.E. F.A.S.T. is a great tool, but those aren't the only possible symptoms.

Other stroke symptoms can include sudden confusion, numbness or weakness—especially on one side of the body—or a sudden severe headache with no known cause.

The word I want you to notice throughout this is sudden.

Someone suddenly isn't acting like themselves.

Something suddenly isn't working the way it normally does.

Their speech suddenly changes.

Their balance suddenly changes.

Their vision suddenly changes.

Pay attention to those changes.

Why Does Every Minute Matter?

You may have heard the phrase:

"Time is brain."

There's a reason for it.

During a stroke, brain tissue isn't getting the blood and oxygen it needs. The longer that continues, the more damage can occur.

It's estimated that during an untreated stroke, around 1.9 million brain cells can be lost every minute.

Think about that for a second.

Every. Single. Minute.

That's why a stroke isn't something you watch for a while to see if it gets better.

Depending on the type of stroke and the individual situation, doctors may have treatments available to restore blood flow or remove a clot. Some of those treatments are extremely time-sensitive.

The sooner someone receives medical attention, the sooner doctors can figure out what's happening and determine what treatment may be appropriate.

Fast treatment can mean the difference between life and death.

But it can also make a difference in what comes afterward.

Walking.

Talking.

Eating.

Using an arm or hand.

Remembering things.

Living independently.

There's no way to predict exactly how a stroke will affect someone, but getting treatment quickly gives that person the best chance possible.

Remember When It Started

If you witness someone developing possible stroke symptoms, try to remember when the symptoms began—or the last time the person was known to be normal.

That information can be incredibly important once they reach the hospital because doctors use timing, along with imaging and other information, to determine which treatments may be appropriate.

If you aren't sure of the exact minute, give emergency responders the best information you have.

But don't waste valuable time trying to figure everything out before calling.

Call 911 first.

Don't Wait Because You're Afraid of Being Wrong

I think this is important enough to say on its own.

You don't have to diagnose the stroke.

That's not your job.

If something is suddenly wrong and you're seeing signs of a possible stroke, call for help.

Maybe it turns out not to be a stroke.

That's okay.

There are other medical conditions that can cause stroke-like symptoms, and some of those can be emergencies too.

I'd much rather see someone get evaluated and find out it wasn't a stroke than have someone wait because they didn't want to "overreact."

Especially when someone is stubborn.

Especially when they're telling you they're fine.

Especially when the symptoms start disappearing.

Call anyway.

Remember: B.E. F.A.S.T.

If there's one thing you remember from this blog, let it be this:

B — Balance loss

E — Eye or vision changes

F — Face drooping

A — Arm weakness

S — Speech difficulty

T — Time to call 911

You don't need to be a nurse, doctor, CNA, caregiver, or medical professional to recognize that something isn't right.

Sometimes knowing what to look for—and being willing to act—is enough to change someone's entire outcome.

And sometimes being the person who says, No, we're not waiting. We're getting you help, is one of the most loving things you can do.

This is only the beginning of the conversation about strokes.

In the next part of this series, we're going to talk about what happens after the stroke: the things everyone can see, the things they can't, and what life after a stroke can actually feel like from the perspective of the person living through it.

— Kayla

Emergency & Medical Disclaimer

This blog is intended for general educational purposes only and is not medical advice, diagnosis, or treatment.

If you or someone around you develops sudden signs or symptoms of a stroke, call 911 immediately. Do not wait for symptoms to improve or disappear.

Even symptoms that go away may be caused by a TIA ("warning stroke") and require emergency medical evaluation.