The 4 typical symptoms of stroke

Every 4 minutes, a person has a stroke in France. We must act at the first warning signs by calling 15 to increase the chances of survival and improve recovery. Here are the warning signs.

A Stroke occurs every 4 minutes in France, recalls the French Neuro-Vascular Society on the occasion of the World Stroke Day which takes place on October 29 2022. On 140,000 stroke victims each year in France, approximately 30,000 die. All ages are affected by stroke. Close 25% of strokes occur before age 65 and the number of strokes between 35 and 64 years increases. As a reminder, stroke occurs in the brain when a blood vessel is clogged (80% of cases) or ruptures and causes bleeding (20%). Loss of sight in one eyethe mobility of an arm, difficulty speaking out loud… Here are the warning signs with Pr Sonia Alamowitch, Head of the Cerebrovascular Emergencies Department at Salpetriere Hospital (Paris, AP-HP).

How long before the stroke do the symptoms occur?

The cerebrovascular accident is manifested by sudden neurological symptoms. “It’s a important feature. The loss of neurological functions sets in suddenly, from one second to another or over a few minutes, sometimes for a few hours but suddenly” insists our interlocutor.

What are the 4 types of neurological symptoms of stroke?

The signs of stroke are related to the lack of blood supply to the brain. We identify 4 types of sudden neurological symptoms :

1. Loss of mobility, typically on a hemibody (complete or partial). For example, the person cannot lift their arm, can no longer move their arm or their leg and their face is crooked (complete) or partially they manage to lift their limb but feel heaviness, with muscle weakness at the level of the arm, the leg and the crooked mouth.

2. Sudden loss of language (aphasia) : the person has difficulty expressing himself or even can’t do it at all, he doesn’t say any words or only partially or he manages to make a few words but it’s very difficult, he has lost his vocabulary. “In the language disorder there can also be understanding: people talk to me but I no longer understand anything” says Professor Alamowitch.

3. Sudden vision loss : either the person no longer sees anything at all (total darkness), or they can only see on one side. She may feel like a visual fog abrupt installation.

4. Sudden loss of balance : the person walks as if he were drunk, with a significant imbalance (ataxia) when he has not drunk anything.

The victim of a stroke does not necessarily show all of these symptoms: “It’s variable, it can be a type of symptom (mobility, eye, editor’s note), sometimes a combination, more or less severe, for example right hemiplegia with loss of language” explains the doctor. Knowing that the left part of the brain controls the right part of the body and vice versa. “The area of ​​the left brain that controls movement on the right side is located near the language area, if the stroke occurs in this area, the person can no longer move the right side and can no longer speak.”

Diagram of a stroke © 123rf/JournaldesFemmes

Can a headache be a sign of a stroke?

Yes. “A very brutal headache, sudden, completely unusual as we have never felt, can testify to a stroke corresponding to subarachnoid hemorrhageanswers Professor Alamowitch. Subarachnoid hemorrhage is different from intracerebral hemorrhage. It characterizes the rupture of a blood vessel in the meninges that surround the brain whereas “cerebral” hemorrhage occurs inside the brain. Of the 20% of haemorrhages responsible for strokes, about 5% are meningeal haemorrhages and 15% cerebral haemorrhages.

Are the symptoms of stroke different in children?

“CVA in children is an exceptional situation and can be really difficult to recognize. The child has difficulty moving, is downcast. In adolescents, as in adults or the oldest, it is the loss of a neurological function (language, movement, editor’s note) which alerts” replies our interlocutor. In figures, less than 1% of strokes occur in people under 18 years old. More than half the time, it is not immediately diagnosed.

“Whether the stroke presents with severe or less severe symptoms, you must call 15, the Samu.”

Are stroke symptoms different in women?

Women are among the first victims of stroke. “They live longer. Age increases the risk of having a stroke, the weight of strokes is greater in them” explains the doctor. They have specific risk factors such ascombination of the pill, smoking and migraine ; the periods at risk of AVC which are the pregnancy, or after menopause ; depression and psychosocial stress to which women are more exposed than men. “There is no literature data showing that there are different symptoms of stroke in women buts women tend to be less attentive to themselves and more to others and therefore less alert comments Professor Alamowitch.

What to do in case of stroke symptoms?

Call 15 immediately. “Whether the stroke presents with severe or less severe symptoms, it remains an absolute emergency. Mild symptoms can get worse very quickly. You must alert by immediately calling the SAMU at 15. For yourself or if you witness a stroke” insists the specialist. From this call comes support.Do not call the attending physician, this can waste precious minutes. To treat a stroke, it is necessary to know if it is due to a clogged or ruptured artery. Only examination of the brain (MRI or scanner) can tell and this examination must be carried out urgently in the hospital. Through the Samu, the patient will be taken in a Neuro-Vascular care unit specializing in stroke. “In the treatment of a stroke, blood flow must be restored as quickly as possible to limit the effects on the brain, explains Pr Igor Sibon, President of the SFNV and Head of the Department of Neurology-CHU of Bordeaux. Every minute saved is 2 million neurons saved and weeks less rehabilitation for the patient who will be able to find his loved ones and his previous life more quickly. Thanks to early management allowing the administration of reperfusion treatment (thrombolysis or thrombectomy), today it is 1 out of 2 patients who are completely cured.”

Thanks to Pr Sonia Alamowitch, Head of the Cerebrovascular Emergency Department at Salpetriere Hospital (Paris, AP-HP). Source: World Stroke Day October 29, 2022 Stroke: every minute counts. Press release, SFNV.

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