Recognising a Stroke: FAST Warning Signs & Emergency Action

Stroke is one of the leading causes of death and disability in India. Yet studies show that most stroke victims do not reach hospital within the critical treatment window. The reason? Many people do not recognise a stroke when it happens. Knowing how to spot a stroke — and acting immediately — can save a life and prevent permanent disability.

What Is a Stroke?

A stroke occurs when blood supply to part of the brain is suddenly interrupted — either because a blood vessel is blocked by a clot (ischaemic stroke, accounting for 85% of cases) or because a vessel bursts (haemorrhagic stroke). Without oxygen-rich blood, brain cells begin dying within minutes.

A TIA (Transient Ischaemic Attack), sometimes called a "mini-stroke," produces the same symptoms but lasts only a few minutes and leaves no permanent damage. However, a TIA is a serious warning sign — 1 in 10 TIA patients suffers a major stroke within 90 days if untreated.

The FAST Test: How to Recognise a Stroke

The FAST method is an internationally recognised tool to quickly identify the most common stroke signs:

Other Stroke Warning Signs

Beyond FAST, watch for these additional symptoms which may indicate stroke:

• Sudden severe headache with no known cause ("thunderclap headache")
• Sudden loss of vision in one or both eyes
• Sudden numbness or weakness on one side of the body
• Sudden confusion, disorientation, or difficulty understanding
• Sudden difficulty walking, loss of balance, or dizziness

Important: Stroke symptoms are usually sudden in onset. Even if symptoms resolve after a few minutes (TIA), seek emergency care — this is still a medical emergency requiring urgent evaluation.

What to Do If You Suspect a Stroke

1. Call emergency services immediately — dial 108 in Andhra Pradesh or call SAI Hospital directly at +91-8331093773.
2. Note the time — write down or remember when symptoms first started. This is critical for treatment decisions.
3. Do not give food or water — stroke can impair swallowing and cause choking.
4. Keep the person calm and lying down — if unconscious, place them on their side (recovery position).
5. Do not give aspirin — unless confirmed by a doctor. Haemorrhagic strokes can be worsened by blood thinners.
6. Go to hospital immediately — do not wait to see if symptoms improve.

Stroke Treatment: The Importance of the Time Window

The most effective treatment for ischaemic stroke is tPA (tissue plasminogen activator) — a clot-dissolving drug that must be administered within 4.5 hours of symptom onset. Patients treated within this window have significantly better outcomes and lower rates of permanent disability.

Interventional procedures such as mechanical thrombectomy (physical removal of the clot) may be an option up to 24 hours after symptom onset for selected patients.

After the Acute Phase

Once stabilised, stroke patients typically require:

• Monitoring and secondary stroke prevention (medications, blood pressure control)
• Physiotherapy for mobility and strength
• Speech and swallowing therapy if affected
• Occupational therapy to regain daily living skills
• Cognitive rehabilitation for memory and attention

Stroke Risk Factors You Can Control

Up to 80% of strokes are preventable. Key modifiable risk factors include:

• Hypertension — the single biggest risk factor for stroke. Keep blood pressure below 130/80 mmHg.
• Atrial fibrillation (AF) — irregular heart rhythm that increases clot risk. Requires anticoagulation therapy.
• Diabetes — poorly controlled blood sugar damages blood vessels.
• Smoking — doubles stroke risk. Stopping smoking significantly reduces risk within 2-5 years.
• High cholesterol — contributes to atherosclerosis and clot formation.
• Physical inactivity and obesity — regular exercise reduces stroke risk by up to 27%.

Stroke Care at SAI Hospital, Rajahmundry

SAI Hospital's Neurology department, led by Dr. Marrela Rajyalakshmi (Consultant Neurologist), provides 24/7 stroke emergency care including:

• Emergency CT brain imaging for rapid stroke diagnosis
• IV thrombolysis (clot-busting therapy)
• Dedicated Neuro ICU with continuous monitoring
• Multidisciplinary stroke rehabilitation team
• Carotid Doppler and echocardiography for stroke workup