Stroke Warning Signs: Pre-Stroke Condition and Early Symptoms

A stroke is an acute disruption of the blood supply to an area of the brain: without oxygen and nutrients, its cells begin to die within minutes. Sometimes a stroke announces itself with a transient ischemic attack — a brief disruption of blood flow. Let us examine the mechanism, the early signs, and the boundary beyond which every minute counts.

What is called a pre-stroke condition

Pre-stroke condition is not a strict medical term; the closest concept in meaning is a transient ischemic attack (TIA). This refers to cases in which blood flow in a cerebral vessel is disrupted for a short time: if the neurological deficit resolves within 24 hours, it is called a transient cerebrovascular accident, or transient ischemic attack. When recovery takes up to three weeks, it is a minor stroke, and persistence of symptoms for longer than a day means a stroke proper.

The mechanism explains the difference. Ischemic stroke occurs when a thrombus or embolus blocks an artery supplying the brain — this type accounts for 70–85% of cases, while intracerebral hemorrhage accounts for 20–25%. In a transient attack the blockage is brief and the cells do not die irreversibly, but the episode itself indicates a problem with the vascular wall. The first description of such an event was left by Hippocrates in 467 BC, and Galen established the term "apoplexy" — "a blow".

Early warning signs of stroke: which symptoms occur

Symptoms most often arise suddenly, within minutes or hours. The F.A.S.T. test is used for a quick check: face — asymmetry when smiling, arm — when both arms are raised one drifts down, speech — slurred or strange, time — call an ambulance.

• sudden weakness or numbness of the face, arm, or leg, especially on one side of the body;
• sudden confusion, difficulty speaking or understanding speech addressed to the person;
• sudden visual disturbance in one or both eyes;
• sudden difficulty walking, dizziness, loss of balance and coordination;
• sudden severe headache with no known cause.

Stroke warning signs a month and a few days before

It is impossible to name exact timeframes over which warning signs appear before a stroke. Stroke symptoms arise suddenly — within minutes or hours. Ischemic stroke often develops at night and without loss of consciousness. A prior transient ischemic attack significantly increases the risk of stroke.

Stroke warning signs in women

No separate "female" set of warning signs has been described: sudden weakness, disturbances of speech, vision and balance, and severe headache look the same in both sexes. The differences lie in the statistics: stroke mortality in men is higher than in women, and incidence rises noticeably starting at age 30 — 95% of strokes occur after age 45, two thirds after 65. Atherosclerosis, diabetes, and atrial fibrillation increase the risk of stroke.

Transient ischemic attack as a warning

A transient ischemic attack is called a mini-stroke. The blood supply to the brain is blocked for a short time, and cell damage does not remain permanent, yet a prior attack substantially increases the risk of a true stroke. What the doctor assesses: the history of symptoms, coordination and balance, strength and sensation in the face, arms and legs, speech and vision. If necessary, brain imaging is performed — computed tomography or magnetic resonance imaging — as well as an electrocardiogram and echocardiography.

Preconditions of stroke and when to call an ambulance urgently

Preconditions of stroke are risk factors. The main one is elevated blood pressure, followed by diabetes, heart disease including atrial fibrillation, smoking, a personal or family history of stroke and TIA, and age. Additional ones include alcohol and drugs, lack of physical activity, high cholesterol, unhealthy diet, and obesity. Cerebrovascular diseases rank second in the structure of mortality from diseases of the circulatory system after coronary heart disease, and 70–80% of survivors remain disabled.

Call 103 or 112 if a person's mouth corner suddenly droops when smiling, one arm weakens and "drifts", speech becomes slurred or unintelligible, vision sharply deteriorates, dizziness with loss of balance appears, or a severe headache occurs for no reason.

This material is for reference: it does not replace a doctor's consultation and examination by a neurologist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer