From the Guidelines
Stroke symptoms typically present with sudden onset of hemiparesis, dysarthria, aphasia, hemianopsia, ataxia, and altered consciousness, and can be identified using the FAST mnemonic: Facial drooping, Arm weakness, Speech difficulties, and Time to call emergency services. The symptoms of a cerebrovascular accident (CVA) or stroke can vary depending on the brain region affected, but common manifestations include:
- Sudden weakness or numbness on one side of the body (hemiparesis) 1
- Slurred speech or difficulty speaking (dysarthria) 1
- Language impairment or difficulty understanding speech (aphasia) 1
- Visual field deficits or loss of vision on one side (hemianopsia) 1
- Loss of coordination or balance (ataxia) 1
- Altered consciousness or confusion 1
- Additional symptoms may include dysphagia (difficulty swallowing), dysphonia (voice changes), paresthesia (numbness or tingling), and vertigo (dizziness) 1 The specific constellation of symptoms depends on which brain region is affected, with anterior circulation strokes (carotid territory) often causing motor/sensory deficits and language problems, and posterior circulation strokes (vertebrobasilar territory) presenting with visual disturbances, dizziness, and coordination problems 1. Prompt recognition of these symptoms is crucial, as timely intervention within the first few hours can significantly improve outcomes through treatments like thrombolysis or thrombectomy for ischemic strokes 1. The use of public health campaigns, such as the FAST mnemonic, has been shown to increase awareness of stroke symptoms and improve timely treatment 1.
From the Research
Symptoms of a Cerebrovascular Accident (CVA) or Stroke
The symptoms of a cerebrovascular accident (CVA) or stroke can be identified through various studies, including:
- A study published in the International Journal of Stroke 2 found that the most frequently reported problems by callers to emergency medical services were collapse or fall (26%) and stroke (25%).
- The same study found that speech problems were the most commonly reported element of the Face Arm Speech Test (FAST) symptoms, with less than 5% of calls mentioning all three FAST symptoms.
- Another study published in the Nursing Standard journal 3 emphasized the importance of rapid identification and prompt transfer to emergency or specialist teams to maximize patients' chances of survival and reduce the risk and severity of long-term disability.
Common Symptoms
Common symptoms of a stroke include:
- Speech problems
- Collapse or fall
- Face, arm, or speech symptoms (as identified by the FAST test)
- These symptoms can be reported by callers to emergency medical services, with speech problems being the most commonly reported element of the FAST symptoms 2.
Importance of Immediate Care
Immediate care is crucial in preserving life and preventing deterioration in patients with suspected stroke, as highlighted in a study published in the Nursing Standard journal 3. Nurses play a vital role in providing optimal immediate care aimed at preserving life and preventing deterioration.
Recognition of Stroke Symptoms
Recognition of possible stroke diagnosis in fall and other presentations should be considered by emergency medical dispatchers, as emphasized in a study published in the International Journal of Stroke 2. Further development and training are needed in the community to improve prehospital stroke recognition and expedite hyperacute stroke care.