Signs of a Stroke
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How to Recognize the Warning Signs of a Stroke

by Dr. Lina Velikova, MD

What does the idea of a stroke invoke in your mind? If you associate the word with fear, you should know that there’s something you can do. Understanding and remembering the signs of a stroke may save your own life someday or the lives of your loved ones.

But what, in fact, is a stroke? Is it a disease, or an event, or a condition? Is it reversible or not? Is there anything that can be done to prevent it or to limit any brain damage if the stroke occurs?

With this article, we will attempt to answer all these questions.

The Significance of Recognizing a Stroke in Elderly People

The risk of stroke increases with aging. Sadly, each year, more than 800,000 Americans become victim to this illness. Approximately every 40 seconds someone has a stroke in the US, whereas every four minutes one person dies from a stroke.

Furthermore, stroke is listed as the fifth leading cause of death in the US after other significant diseases and events such as heart and respiratory conditions, cancer, and accidents.

Even if a person survives a stroke, their quality of life decreases in an overwhelming proportion of cases. However, the negative effects of a stroke can be diminished if appropriate measures are taken in time.

What Happens if You Have a Stroke?

A stroke happens when the bloodstream to the brain is reduced or cut off. The lack of oxygen and nutrients harms the brain tissue. Usually, only a part of the brain is affected. Brain cells begin to die within minutes, making stroke a medical emergency. However, some subtle clinical signs in the patient could direct the diagnosis to stroke. Quick and responsive actions are critical.

The good news is that the prompt handling of a stroke can lessen brain damage and prevent future complications.

What Are the Stroke Symptoms to Look out For?

Several symptoms and signs can direct attention to a possible stroke. If you suppose that you or someone else may be having a stroke, you should pay attention not only to the symptoms themselves, but to the number of them. The exact beginning of these signs and symptoms is also important, as well as the length of time they’ve gone on. All the small details about the symptoms can influence the success of treatment.

Here, we list the most common stroke signs:

  • Sudden difficulty with verbal communication and understanding – Patients have trouble speaking, like slurring their words, and they also experience confusion and struggle in understanding speech.
  • Unexpected numbness or paralysis of a body part – Sudden development of any numbness, weakness, or paralysis on usually one side of the face, or in an arm or leg, are common features of stroke in elderly people. A simple test could be useful. If one arm begins to fall after raising both your arms over your head at the same time, you may be having a stroke. Another sign is the dropping off of one side of your mouth when you try to smile.
  • Sudden blurred or blackened vision – Trouble with seeing through one or both eyes or double vision are alarming signs.
  • Difficulty walking – Sudden dizziness, stumbling, or loss of balance and coordination could be attributed to the symptoms of a stroke.
  • Sudden severe headache – A headache accompanied by harsh vomiting, dizziness, or altered consciousness may indicate you’re having a stroke.

If you spot any of the above-listed signs and symptoms in someone, even if they fluctuate or disappear, don’t consider this normal.

Remember the acronym FAST,” which stands for “face, arms, speech, and time.”

Signs of a Stroke

Then, while thinking of it, perform the following stroke test as soon as possible:

  • Does one side of the face or mouth drop if a person smiles? (Face)
  • Is one arm unable to rise or does it drift downward after the person raises both arms? (Arms)
  • Is their speech slurred or strange when asked to repeat a simple phrase? (Speech)
  • If you detect any of these signs, seek medical attention immediately—i.e. call 911. (Time)

Don’t wait for these signs of stroke in elderly adults to stop. Oversee the person while waiting for emergency assistance. If you are with someone you believe is having a stroke, time matters. The longer a stroke stays untreated, the higher the potential is for brain damage and disability.

Moreover, strokes don’t distinguish between people based on age, sex, or race, although more women have strokes than men. In addition, the signs of a stroke in a woman don’t differ significantly from the signs of a stroke in a man.

Causes and Types of Stroke

Interruption of blood flow in the brain can be caused by different underlying reasons. Whether it’s a blocked artery or a blood vessel leaking, the consequences could lead to severe damage to the brain. In comparison, some people may experience only a temporary interruption of blood flow to the brain that doesn’t cause permanent injuries.

There are three types of stroke, which are categorized by their cause:

Ischemic Stroke

This occurs when an artery in your brain becomes narrow or blocked by a thrombus or embolus (blood clot), leading to a serious shortening of blood flow (a condition called ischemia). Ischemic strokes account for about 80% of all strokes.

Hemorrhagic Stroke

This kind of stroke occurs when a blood vessel in your brain ruptures or leaks. Hemorrhages in the brain can result from different conditions that affect blood vessels, including uncontrolled high blood pressure, medication with anticoagulants, aneurysms of blood vessels, arteriovenous malformation, etc.

Depending on the location of the vessel rupture, the stroke could be due to an intracerebral or subarachnoid hemorrhage. Unfortunately, after the bleeding, the brain blood vessels may widen or narrow irregularly, limiting blood flow and leading to further brain cell damage.

Transient Ischemic Attack (TIA)

A TIA stroke is a brief condition with symptoms similar to those of a stroke. A transitory decrease in blood supply to part of your nervous system causes TIA; fortunately, it only lasts a few minutes. Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of the brain. Also referred to as a mini-stroke, a TIA stroke results in no permanent tissue damage, which means that the symptoms related to TIA are temporary.

However, it is crucial to seek medical care immediately even if your symptoms seem to diminish. A TIA can eventually lead to a full-blown stroke. Thus, it represents a higher risk of permanent damage later.

Sometimes it’s not possible to distinguish a stroke from a TIA based only on the signs because mini-stroke symptoms in the elderly are very similar to those of a stroke. It’s important to notice that even if the symptoms last for under an hour, there’s still a risk of permanent brain tissue damage. This fact makes TIA as deadly as other stroke types. Prompt medical care is critical to avoid any damage to the brain.

Furthermore, according to the alarming statistics from the Center for Disease Control and Prevention, TIAs should be treated as a warning event for the development of a major stroke within a year. Therefore, the mild stroke symptoms of TIA should be treated like an alarming experience with a similar mortality rate to other types of stroke.

Strokes could also be divided anatomically as right-hemisphere and left-hemisphere, cerebellar, and brain stem strokes. Each of them differs in the clinical presentation and the prognosis of the patient.

Signs of a Stroke

Diagnosing Strokes and Stroke Treatment

The priority of the emergency team is to stabilize your symptoms and overall medical condition. Then the doctors will define if you’re having a stroke, what the cause is, and which brain region is affected before determining the most appropriate therapy. It’s necessary to rule out other possible causes, such as a brain tumor or a drug reaction.

If your doctor suspects a stroke, the following tests should be performed:

  • Detailed anamnesis
  • Physical examination, together with blood pressure measurements
  • Blood tests
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Carotid ultrasound
  • Cerebral angiogram
  • Echocardiogram

The proper treatment can vary greatly depending on the different types of strokes in elderly patients. Some of the available medications should be used with caution.

Emergency treatment for an ischemic stroke comprises of quickly restoring blood flow to the brain, which can be achieved by an intravenous injection of a tissue plasminogen activator (tPA) or emergency endovascular procedures directly inside the blocked blood vessel. In case of an ischemic stroke or TIA, the doctor may recommend such medications as antiplatelet drugs, and anticoagulants to prevent having another stroke in the future.

In contrast, a hemorrhagic stroke requires emergency treatment that aims to control bleeding and reduce intracranial pressure while simultaneously maintaining blood volume with transfusions. Surgical procedures might also be needed to minimize future risk.

From all kind of strokes, recovering from a mini-stroke is the most favorable. After emergency treatment, care is focused on recovering as much function as possible in order to make an early return to independent living. Most stroke survivors are pressed to attend a rehabilitation program.

Maintaining self-esteem and relationships with others, as well as sustaining interest in the world, are essential parts of every patient’s recovery.

Risk Factors for Stroke in Senior Citizens

You have to be conscious of the risk factors that can increase your chances of having a stroke in order to prevent it.

  • Lifestyle risk factors – They comprise of obesity or being overweight, physical inactivity, heavy drinking, cigarette smoking or exposure to cigarette smoke, and the use of illegal drugs (i.e. cocaine and methamphetamines).
  • Medical risk factors – These include hypertension (above 120/80 mm Hg), high levels of cholesterol; chronic diseases such as diabetes, obstructive sleep apnea, cardiovascular disease; a previous heart attack or transient ischemic attack; and a personal or family history of stroke.

After-Effects of a Stroke in Elderly People

Other factors linked to a higher risk of stroke include age, race, sex, and hormones. People aged 55 or older have a higher risk of stroke than younger people. In addition, complications are seen more often in elderly patients, and their recovery can often be prolonged. Needless to say, there’s a clear relationship between stroke recovery and age.

Stroke complications can be temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected. They may include the following:

  • Paralysis or impaired muscle control, usually on one side of the body
  • Problems with speaking, swallowing, or eating
  • Memory loss or difficulties in thinking, making judgments, reasoning, and understanding concepts
  • Showing an inability to control emotions or developing depression
  • Pain or bizarre sensations in parts of the body affected by stroke
  • Changes in behavior and the ability to care for themselves

A stroke in an 80-year-old adult could be a challenge. Physical therapy may help the patient return to their everyday activities, especially if it’s alongside therapy with a speech-language pathologist. Like any other brain injury, the success of treating stroke complications varies from person to person. However, they may be improved over time.

How to Prevent a Stroke

Preventing a stroke is based on three main measures. Furthermore, these measures might help prevent another stroke if there’s a history of a previous stroke or TIA.

  • Know your stroke risk factors
  • Follow your doctor’s recommendations
  • Adopt a healthy lifestyle

The care received in the hospital and follow-up afterward may be helpful as well. Controlling the stroke causes is the basis for stroke prevention strategies, so it’s best to follow these guidelines:

  • Keep your blood pressure within the normal ranges
  • Be physically active every day
  • Learn how to manage stress
  • Maintain a healthy weight
  • Limit your sodium and alcohol intake
  • Lower the amount of cholesterol and saturated fat in your diet
  • Quit tobacco use
  • Keep diabetes under control
  • Treat obstructive sleep apnea
  • Avoid illegal drugs
  • Eat healthy and balanced food

Not only will you lower your stroke risk with these steps, but you’ll also decrease your risk for other diseases like heart disease, diabetes, and cancer. For tips on the best ways to take care of yourself, read our articles on

Signs of a Stroke


What are the early warning signs of a stroke?

A stroke can happen gradually even if the patient has one or more sudden symptoms. The following are some early warning signs:

  • Numbness, weakness, or paralysis in one arm or leg or on one side of the face
  • Confusion or difficulties understanding other people
  • Problems talking
  • Impaired vision (one or both eyes)
  • Trouble walking or staying balanced and coordinated
  • Dizziness
  • Headaches for no reason, which are usually very severe

Exhibiting any combination of these symptoms is enough justification for calling an ambulance.

What are the first signs of a mini-stroke?

The most common signs of this type of stroke include (but are not limited to) the following:

  • Dysphasia and dysarthria—a language disorder or physical difficulty speaking, respectively
  • Vision problems
  • A strange sense of taste and smell
  • Confusion and altered consciousness
  • Dizziness and balance issues
  • Tingling/numbness and weakness on one side of the face or body
  • Severe headache
  • Passing out

What causes a stroke in the elderly?

With increasing age, the possibility of suffering a stroke increases. In the elderly population, the most common is the embolic stroke, primarily due to atrial fibrillation, which occurs more frequently with increasing age. Amyloid angiopathy, however, is the leading cause of a spontaneous intracerebral hemorrhage. Still, it is not fully clear how the older brain handles the ischemic stress.

Therefore, strokes in the elderly represent unique problems that deserve individual solutions.

How can I tell if I am having a stroke?

A stroke can happen to a given person at any time. However, the game changer lies in planning for the emergency. Therefore, be prepared! If you have any medical conditions, wear some identification, such as a medical bracelet, that describes your medical status, allergies, and any medications you take.

If you learn the warning signs of a stroke, and if your family and friends do the same, chances of a good outcome after a stroke greatly improve. Teaching your children the FAST (face, arms, speech, time) test, plus the importance of calling 911 immediately, gives you a chance to survive after a stroke and to minimize the risk of complications developing.

How long are you in the hospital after a stroke?

The stay at the hospital after a stroke can vary from a few days to some months depending on the stroke’s severity. Patients are usually discharged home after they can get around safely, either in a wheelchair or by walking, and are able to get in and out of bed alone.

Besides, the support available at home is also essential. Some people are provided with a care package at home. A small portion of patients discharge themselves earlier, but they usually encounter problems accessing rehabilitation services as a consequence.

Can a stroke kill you instantly?

Not all strokes are fatal. Mild and medium strokes aren’t usually deadly in the short term. In other words, you are not likely to die in the first weeks or months after a mild stroke. However, you might get a complication like a pulmonary embolism, which can kill you, or a swallowing problem that could make you choke to death. This is valid also for mini-strokes in elderly adults.

In contrast, severe/massive strokes are often fatal in the first few days or weeks due to brain swelling, leading to a coma or the need for breathing machines. Sometimes increased intracranial pressure requires brain surgery to relieve the pressure.

Strokes in the brainstem are the most dangerous, as well as hemorrhagic strokes caused by an aneurysm rupture, where the risk of death is up to 50%.

Can an elderly person recover from a stroke?

As it relates to stroke recovery rates, the National Stroke Association says that 85% of stroke victims survive, and among those, 75% continue to experience adverse effects from the stroke, ranging from minor impairment to severe complications. Many factors determine the possibility of a full return to normalcy after a stroke in an elderly patient.

The initial recovery phase begins almost right after the patient has been stabilized, usually within the first 24 hours following the stroke. Rehabilitation and speech therapy is a critical component of the recovery stage.


As of right now, strokes are the fifth leading cause of death in the US and a significant cause of severe lifelong disabilities. Learning the signs of a stroke is essential to minimizing the consequences of this potentially life-threatening event. You want to be capable of detecting the early symptoms so that you can get medical help as soon as possible—every second matters because each moment without oxygen can bring further damage to your brain, your most precious organ.

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1 comment

Phyllis Poole May 19, 2019 - 10:09 pm

On strokes A friend who was a nurse said a doctor held an all day seminar on strokes and said if a person is in
Need iof. vit. e and b6 they could be opportune for a stroke!
My mother had a stroke and I know she was lacking B6 as she was having hot flashes well into her 90s. When I had. Hot flashes I took b6 as told by an Adelle Davis nutrition book and they stopped.


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