“Can stroke be identified early in a person?”

History In the family, PERSISTENT HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, and obesity with diabetes metabolic syndrome are early signs of an impending stroke.

Early signs of stroke include confusion, slurred speech, facial droop, arm or leg weakness, difficulty holding a cup, difficulty with gait. Sometimes dizziness, double vision, and severe headache can also be a sign.

That is a multi-faceted question, depending on how early and how definitively. Many persons who go on to have a stroke have warning symptoms in the hours to days prior--transient impairments (often called TIAs) that resolve after a few minutes. If these brief episodes of one-sided weakness / facial appearance change, or speech changes are mis-attributed by the patient to an unlikely medical cause, then they cannot aid the patient by getting them in to care earlier--and before the onset of a stroke.

As to once the blood vessel is blocked, symptoms come on immediately as the brain does not tolerate lack of blood flow to deliver its nutrients and oxygen. If, alternatively, the vessel leaks, those symptoms intensify over time, usually starting with an intense/sudden/severe headache, and symptoms can further develop or progress as the bleeding into the closed-space of the skull continues, depending upon where the event is taking place.

If in doubt, call 911. Time is brain.

Donald W. Alves, MD, MS, FACEP