Unfortunately, many patients still arrive at the hospital too late to receive treatment. Since stroke symptoms often do not include pain or clear signs of distress, and because patients are frequently unaware of their functional impairments, they or their family members may not seek help quickly enough. The common symptoms of a stroke include the sudden appearance of facial drooping or asymmetry, weakness in one arm and/or leg, and difficulty communicating. If one or more of these symptoms occur, it is crucial to immediately call an ambulance and go to the nearest emergency department.
75% of stroke patients present with typical symptoms, but the rest arrive at the hospital with less common signs, making it harder to identify them quickly and treat them in time. Most of these symptoms are nonspecific to stroke and can also appear in other conditions.
1. Sudden Dizziness Dizziness is one of the most common complaints that bring patients to the emergency room. Most causes of dizziness are not related to stroke. However, a blockage of blood vessels supplying the brainstem or cerebellum can cause severe dizziness and instability. Dizziness caused by stroke typically appears with additional signs, such as double vision, difficulty standing or walking, and weakness or sensory impairment on one side of the body. It is a prolonged sensation and is not usually associated with hearing impairment.
2. Sudden Vision Disturbance (Unilateral) Sudden vision loss in one eye is a dangerous symptom and requires immediate referral to the emergency department. If the disturbance is monocular, it may be part of an eye-related condition but could also indicate a lack of blood flow to the artery supplying the eye. In such cases, it is critical for the patient to undergo an urgent eye examination in the hospital. An ophthalmologist can identify inadequate blood supply to the eye and urgently refer the patient for treatment, such as IV TPA or surgery.
3. Sudden Vision Disturbance (Bilateral) Our vision relies on both eyes working together. The brain combines the images from both eyes into a single perception. A sudden vision disturbance involving both eyes, particularly on one side (right or left), raises suspicion for a stroke and requires immediate attention by ambulance to the emergency department. Patients may not be aware of the issue, but those around them may notice them bumping into objects on one side.
Bilateral vision disturbances are often less dangerous and can be related to migraines. Visual disturbances sometimes precede migraines and can mimic a stroke. In most cases, vision disturbances related to migraines last briefly and are accompanied by typical one-sided headaches and nausea (often with vomiting).
4. Instability in Standing or Walking This is also a common reason for patients to seek emergency care. Many patients who report dizziness also complain of instability while walking or standing. If a patient experiences sudden difficulty with balance, even without significant dizziness, and shows a tendency to fall to one side, it is highly suggestive of a stroke, and an ambulance should be called immediately.
Summary:
The most common signs of a stroke include the sudden appearance of weakness on one side of the body, facial drooping, and difficulty communicating (difficulty speaking or understanding). Less common but important signs to watch out for include sudden dizziness with additional symptoms like instability in walking or standing, one-sided or bilateral vision disturbances, and sudden instability in balance.
The sudden onset of severe motor (movement) or cognitive (mental) impairment should raise suspicion for a stroke or another serious condition, requiring urgent referral to the emergency room via ambulance.
