According to the Centers for Disease Control and Prevention (CDC), someone in the United States has a stroke every 40 seconds, and every four minutes, a person dies from the condition. What makes a stroke such a scary, and deadly, type of disease is that the symptoms often come on suddenly, allowing little time to seek necessary medical attention. In other words, there are very few early warning signs of a stroke. If you suspect you or someone else is having a stroke, the CDC advises employing the FAST acronym, which means look for: facial drooping on one side, one arm drifting downward while raised, slurred or strange speech—and “time,” which refers to the recommendation that you call 9-1-1 right away if you notice any of the aforementioned symptoms. And while this is a helpful technique to identify a stroke in the moment, experts have also found a few things that may indicate a stroke could happen in the future, whether days, weeks, and even years down the line. Read on to discover five early warning signs of a stroke experts say you need to know.
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You experience facial weakness, weakness in your arm or leg, new confusion, difficulty speaking, and vision impairment.
Having an ischemic stroke—the result of blood clots or narrowed arteries reducing blood flow to the brain—means you’ve got a matter of minutes before your brain cells begin to die due to insufficient oxygen. However, according to a 2005 study published in the journal Neurology, many patients will experience a transient ischemic attack (TIA), a “warning stroke” or “mini-stroke,” before that happens.
The symptoms of a TIA can occur up to seven days prior to full ischemic stroke and are similar to those experienced with the latter condition, including numbness or weakness of the face, arm, or leg (especially on one side of the body); new confusion; difficulty speaking; and vision impairment in one or both eyes. While these symptoms seem temporary, they should be addressed immediately when noticed.
“The timing of a TIA is critical, and the most effective treatments should be initiated within hours of a TIA in order to prevent a major attack,” study author Peter M. Rothwell, MD, PhD, a clinical neurologist at Radcliffe Infirmary in Oxford, said in a statement.
The CDC says that a TIA is a likely warning sign of a future stroke and requires immediate medical attention, though it usually lasts no more than five minutes.
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You notice a sudden loss of balance while walking.
If you notice yourself feeling unsteady on your feet, especially if it is out of the blue, you should address it with your doctor immediately.
A problem with your balance could not only be a sign of a full-blown stroke, but also a TIA, meaning the symptom could occur up to a week prior to a major stroke.
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You experience sudden headaches, numbness, or tingling.
According to the experts at Cardiac Screen, an independent medical clinic in London that provides specialist cardiac care and heart screening, “the signs of a stroke often appear suddenly, but that doesn’t mean that you won’t have time to act. Some people will experience symptoms such as headache, numbness or tingling several days before they have a serious stroke.”
A 2010 study published in the Handbook of Clinical Neurology found that up to 65 percent of people who have a stroke report experiencing a headache beforehand.
Your cognitive skills begin to decline.
Sometimes, even more subtle changes could be the sign of a stroke to come years down the road. A 2021 study from Erasmus MC University in the Netherlands published in the Journal Of Neurology Neurosurgery & Psychiatry tracked 14,712 participants between 1990 and 2016. At the beginning of the study and periodically thereafter, participants underwent a series of forensic interviews and physical tests that measured everything from memory, speaking abilities, and reaction times to how well they could handle daily chores, like cleaning, managing personal finances, and cooking.
Over the course of the study, 1,662 of the participants suffered a first stroke at the average age of 80. After matching each person who had a stroke with three participants who did not, comparisons of the forensic and physical tests showed that participants began showing a decline in their mental performance up to a decade before the actual stroke took place.
“Our findings demonstrated that future stroke patients start to deviate from stroke-free controls up to 10 years before the acute event, suggesting that individuals with cognitive and functional decline are at a higher risk of stroke and are possible candidates for prevention trials,” Alis Heshmatollah, MD, a neurology resident at Erasmus MC University and the study’s lead author, wrote in the published findings.
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You go through menopause before age 40.
A recent study published in the American Heart Association (AHA) journal Stroke analyzed the risk of a stroke for postmenopausal women. Researchers monitored more than 16,200 postmenopausal women between the ages of 26 and 70 in the Netherlands for nearly 15 years, observing a total of 830 strokes. The study found that women who experienced menopause before the age of 40 were 1.5 times more likely to experience an ischemic stroke than women who underwent menopause when they were between 50 and 54 years old.
“It is of utmost important for all women to try and achieve optimal cardiovascular health before and after menopause, but it is even more important for women with early menopause,” study co-author Yvonne van der Schouw, PhD, a professor of chronic disease epidemiology at Utrecht University in the Netherlands, said in a statement.
In addition to the increased risk for women who go through menopause before age 40, researchers found that for women over the age of 50—which is near the average onset age for menopause—stroke risk decreased by 2 percent each year menopause was delayed.
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