Stroke Signs & Symptoms

When it comes to spotting a stroke, there’s a helpful acronym you can use to identify the most common symptoms – BE FAST.

What each of the letters mean:

B
Balance: Does the person have a sudden loss of balance?

E
Eyes: Does the person have double vision or are they unable to see out of one eye?

F
Face: Ask the person to smile. Does the person’s face look uneven?

A
Arms: Have the person raise both arms. Does one arm hang or drift down?

S
Speech: Have the person repeat a simple sentence. Is their speech slurred or do they have trouble speaking?

T
Terrible headache: Does the person suddenly have a headache that feels like the worst headache of their life? If so, it is time to call 911.

Call 911 at the first sign of stroke so you can get to the nearest emergency room.

While anyone could have a stroke, there are certain risk factors that increase your chance of having a stroke. Some of these risk factors cannot be changed, but many of them can be managed through medical treatment and lifestyle changes.

Risk factors that cannot be changed include:

• History of prior strokes or TIAs: You are at higher risk for having a second stroke or TIA after you have already had one.
• Older age: For each decade of life after the age of 55, your chance of having a stroke more than doubles.
• Race: African Americans are at a higher risk for death and disability occurring from a stroke compared to whites. This is partly because African Americans have a greater risk for high blood pressure.
• Gender: Stroke occurs more often in men, but more women die from stroke than men.
• Heredity and genetics: The chance of having a stroke is greater in people with a family history of stroke.

Risk factors that can be managed through medical treatment and intervention include:

• High blood pressure: High blood pressure is the most important risk factor for stroke. Having a blood pressure of 130/80 mm Hg or higher can damage blood vessels that supply blood to the brain.
• Heart disease: This is the second most important risk factor for stroke, as many conditions associated with heart disease can lead to problems in blood flow. Many risk factors for stroke and heart disease are the same. 
• Diabetes: Over time, high blood sugar will damage your heart, kidneys, eyes and nerves. Keeping blood sugar levels normal prevents complications from diabetes. Monitoring A1C levels can help with long-term blood sugar control.
• High cholesterol and lipids: These contribute to the thickening or hardening of the arteries (atherosclerosis) and are caused by a buildup of plaque. Plaque buildup on the inside of artery walls can decrease the amount of blood flow to the brain, leading to a stroke. Diet modifications and medications can help lower cholesterol and lipid levels.
• Abnormal heart rhythms: Conditions like atrial fibrillation (AFib), which is an irregular heartbeat, can lead to clots forming in the heart. These clots can travel to the brain and cause a stroke. Managing this stroke risk factor can include medications and other treatments. 
• Sleep apnea: Sleep apnea has been found to contribute to stroke risk. After suffering a stroke, sleep apnea can become more prevalent. A good night’s sleep is essential for brain and cardiovascular health.
• Cardiac structural abnormalities: This includes damaged heart valves (valvular heart disease), which can cause long-term heart damage. Over time, this can raise your risk for stroke.
• Certain blood disorders: Some blood disorders can increase your risk for a stroke. Sickle cell disease causes abnormal blood cells to stick to vessel walls, which then blocks blood flow. For people whose blood clots too easy or not enough (e.g. Factor V Leiden, hemophilia), they may also have an increased risk of stroke.
• Birth control pills (oral contraceptives) and pregnancy: These can cause blood to clot easier which increases one’s risk of stroke.

Risk factors that can be managed through healthy lifestyle changes include:

• Smoking and vaping: Using these products can lead to damages within the blood vessels and cause a stroke. Smoking almost doubles your risk for an ischemic stroke. Exposure to secondhand smoke also increases one’s risk. If you are a smoker, seek help to quit smoking.
• Lack of exercise: Having a low activity level is a known stroke risk factor. Adults should participate in at least 150 minutes of moderate physical activity per week to limit their risk.
• Obesity: Obesity is linked to an increased risk of diabetes and stroke. A recommended body mass index (BMI) is less than 25, which can be calculated using one’s height and weight.
• Excessive alcohol use: More than one drink per day for women and more than two drinks per day for men can raise the risk of stroke. Binge drinking can also lead to stroke.
• Illegal drugs and drug abuse: Drugs like cocaine, ecstasy, amphetamines and heroin have been closely linked to strokes, heart attacks and many other cardiovascular problems. Additionally, a 2024 study reported that using cannabis daily can increase stroke risk by 42%.

It’s important to seek professional help from your primary care provider before you take any substantial actions to address your risk factors.

The best way to prevent a stroke is to know your risk factors (see above question) and to get professional help in treating and managing your risk. Some ways people typically manage their risk factors include:

• Lifestyle changes like exercising, maintaining a healthy weight, quitting smoking, limiting alcohol use, and making healthy food choices.
• Medications like blood thinners and cholesterol-lowering drugs.
• Frequent medical screenings and proper management of other health conditions.

Treatments for stroke vary depending on the type of stroke and the individual patient’s circumstances. Call 911 right away if you or someone near you is experiencing stroke symptoms.

Ischemic strokes are typically treated with a clot-busting drug or through the removal of the clot (thrombectomy). Whether or not these can be performed depends on the patient’s medical history and when the stroke symptoms began.

Hemorrhagic strokes are typically treated by controlling blood pressure. Other medications may be given to assist with the recovery process.

If patients have an ischemic stroke and are eligible for treatment, they may fully recover from their stroke.

Most patients will have residual and ongoing issues related to their stroke after they’ve received medical treatment. Sanford Health has a rehabilitation team that specializes in stroke recovery and helps patients safely improve their level of function.

Recovery is often a long process, and most of the large improvements occur in the early stages. As time goes on, recovery typically seems to slow down, but progress can still be made at any stage.