A stroke can strike without warning, and every minute counts when it does. It happens when the blood supply to your brain is cut off, causing severe damage in a short amount of time. While many of us are familiar with the common warning signs (BEFAST), other, often overlooked symptoms could be just as crucial to spotting a stroke early.
Toby Gropen, M.D., professor in the UAB Department of Neurology, provides insight into recognizing the signs of stroke and the latest advancements in stroke treatment.
Silent strokes
Strokes don’t always present with immediate symptoms; some can occur silently, much like silent heart attacks, with no obvious signs.
“The symptoms of a stroke are related both to the size of the stroke and the location of the injury,” Gropen explained.
When a stroke goes unnoticed or undiagnosed, it can have serious consequences down the line. “Approximately 25 percent of strokes in the US are recurrent, that is, they occur in patients who have had a prior stroke,” Gropen stated. “The risk of mortality and long-term disability increases with each subsequent stroke.”
The effects of a stroke can vary widely depending on which part of the brain is affected. Since the brain controls everything from movement to emotions, behavior, and sensory functions, damage in one area can lead to impairments in vision, speech, mood, or personality.
Stroke has no age limit
Contrary to popular belief, strokes are not limited to older adults.
“They can and do affect people of all ages, including young adults,” Gropen stated. “While the overall risk increases with age, younger individuals are not immune.”
Strokes in younger people often stem from less traditional causes, such as trauma, blood clotting disorders, heart abnormalities, autoimmune diseases, or even drug use, making diagnosis and prevention especially important in this age group.
Risk factors and overlapping conditions
Most strokes are associated with common risk factors, which fall into two categories: non-modifiable and modifiable.
“Non-modifiable risk factors include age, sex, family history, race, and ethnicity,” Gropen explained. “Modifiable factors, those that can be addressed through lifestyle changes or medical treatment, include high blood pressure, diabetes, high cholesterol, heart disease - especially atrial fibrillation, obesity, smoking, excessive alcohol consumption, and the use of drugs.”
Physical inactivity is a significant and often overlooked contributor to stroke risk. Making healthy lifestyle changes, including regular exercise, can play a powerful role in prevention.
In addition to these factors, certain health conditions and medical treatments can also influence stroke risk. “Patients with migraine have a minimal increased risk of stroke,” Gropen noted. “Other factors, such as cancer, pregnancy, or specific medications, may also elevate stroke risk in certain individuals.”
Why every minute counts
When it comes to stroke, immediate medical attention is critical.
“I can’t emphasize enough how important rapid treatment is to have the best possible outcome,” Gropen said. “Time is brain. Patients who receive treatment within the first few hours after symptom onset have significantly better outcomes, and those treated within the first hour often have the best outcomes.”
Earlier intervention dramatically improves the likelihood of preserving brain function and reducing long-term disability. Recognizing the signs of stroke quickly and seeking immediate emergency care can truly be life-saving.
Advances in treatment and prevention
Recent years have brought remarkable advancements in stroke treatment and prevention. One of the most notable developments is the advent of catheter-based procedures for removing blockages in large blood vessels, which are now available at advanced stroke centers, such as the UAB Comprehensive Stroke Center. Additionally, the availability of newer, safer blood thinners, such as direct oral anticoagulants, has made stroke prevention more effective and widely accessible.
“I’m particularly excited about diagnostic technologies that may allow us to diagnose stroke earlier and faster, even before people arrive at the hospital,” Gropen said. “One example is ambulance-based CT scans, or mobile stroke units. In urban areas, these have improved access to timely clot-busting medication.”
As these technologies continue to advance, they promise to enhance early diagnosis and treatment, ultimately improving patient stroke outcomes.
Support critical UAB stroke research by visiting https://sites.uab.edu/strokestat/