“Like Turning Off a Light Switch”: Signs and Symptoms of Stroke

Slurred speech, an impaired gait, paralysis on one side of the face, arm, and/or leg—these are all signs of a stroke, especially if they appear suddenly. If you believe you or someone else is experiencing a stroke, call 911 immediately. Strokes are an emergency, and waiting can result in serious brain injury and even death.

Carolyn Brockington, MD

It this Q&A, Carolyn Brockington, MD, Director of the Stroke Center at Mount Sinai West and Mount Sinai Morningside, and Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai, discusses the signs and symptoms of a stroke, the difference between a stroke and a mini stroke, and why you must act fast.

What is a stroke?                                                                                                         

Simply put, stroke is an injury to the brain caused by a reduction of blood flow—for example, a blood vessel is blocked by a blood clot. Strokes are an emergency because there is a restricted time period—just a few hours—for people to come in for treatment, where doctors can try to administer certain therapies to improve blood flow in order for the affected part of the brain not to be injured.

What are the signs and symptoms?

The signs and symptoms from stroke have to do with how the brain is organized. Primarily, the left side of the brain controls the right side of the body, and the right side controls the left. Let’s say somebody is not getting enough blood flow on the left side of the brain, depending on the part of the brain affected, they might develop right-sided weakness or right-sided numbness, or difficulty speaking, or difficulty understanding speech, etc. If someone has a stroke on the left side of the brain in the back, they may have vision problems but they’ll be able to walk around and speak. If they have a stroke towards the front of the brain, they might have more of a language problem but no vision disturbance. While it’s very hard to tell people exactly what type of symptoms they would have, the appropriate thing is to understand that the symptoms are sudden, like turning off a light switch. Pay attention to balance, eyesight, face asymmetry, arm or leg movement, speech or language.

Who is most at risk?

Everyone is at risk for stroke. Most people think you only have to worry about stroke when you are old. The truth is that the incidence of stroke increases as we get older, because some of the risk factors or the medical conditions that we know that increase stroke increase over time—high blood pressure (hypertension), diabetes, heart disease, elevated cholesterol, etc. However, the most important thing to understand is that anybody can have a stroke at any age. The fact that stroke risks increase with age doesn’t mean it can only happen when you get older. There are different reasons people might have a stroke at different ages.