Stroke Symptoms: What Are the Early Signs of Stroke?

An individual’s risk of stroke increases with age. As Singapore’s senior population grows, it is essential that people can recognise the early signs of this disease. This will help elderly loved ones receive the immediate medical attention they need to prevent the devastating long-term damage of stroke. 

In this guide, we explain how you can quickly identify stroke symptoms. We also discuss the long-term effects of stroke as well as the factors that influence the recovery rate among stroke survivors.

1. What is a Stroke?

A stroke is a cerebrovascular disease characterised by the formation of a blood clot or the sudden rupture of an artery affecting the blood flow in the brain. When this occurs, oxygen circulation is disrupted, leading to brain cell damages. Depending on the type of stroke and how quickly treatment is received, a stroke can leave behind temporary or permanent functional impairments.

2. Types of Stroke

Stroke is classified into two major types – ischemic and hemorrhagic. 

  • Ischemic stroke - Caused by blood clotting that blocks blood flow in certain areas of the brain.
  • Hemorrhagic stroke - Caused by an arterial rupture which produces internal bleeding within the brain or between the brain and skull.

While both types of stroke can lead to severe consequences, individuals are more likely to suffer from permanent damage or develop severe disabilities from a hemorrhagic stroke. This is because the arterial rupture causes excessive pressure on the brain. In Singapore, approximately 80% of strokes are ischemic strokes, and 20% are
hemorrhagic strokes, according to data from National Registry of Diseases Office

Additionally, Transient Ischemic Attack (TIA) - a mild type of stroke - happens when there is a brief interruption of blood flow to the brain. This may cause temporary stroke-like symptoms but often does not lead to permanent long-term effects. As such, TIA is also known as ministroke, or silent stroke. 

A ministroke can be an early warning sign of a major stroke. Unfortunately, most patients are not aware of it, until they experience a more serious stroke or get a brain MRI for another reason and the scan shows brain damages linked to a stroke. In all cases, being aware of stroke symptoms and seeking immediate medical attention is the best way to minimise the severity and long-term impacts of any stroke. 

Ninkatec_ A stroke can be caused by a blood clot or an artery rupture

3. Common Causes of Stroke

Existing cardiovascular disease, unhealthy lifestyle habits, old age, and other comorbid medical conditions are the more common causes of strokes. Cardiovascular disease, in particular, is closely linked to higher stroke incidence since they share similar risk factors. The common contributors to heart disease and stroke include:

  • High blood cholesterol
  • High blood pressure (hypertension)
  • Diabetes
  • Chronic stress
  • Inadequate cardiovascular exercise
  • Obesity
  • Smoking

If you have one or more of the above risk factors, it is vital to discuss risk management measures with your doctor. They often involve making lifestyle changes. If you are unsure of your risk, a general health screening, or a heart health screening, can help you get a baseline of your cardiovascular health and risk level. 

4. Symptoms: Early Signs of Stroke

Recognising the early signs of a stroke when it occurs is essential to preventing further brain damage. The acronym B.E. F.A.S.T. can help you assess and detect strokes more easily:

  • Balance - Poor coordination, dizziness, and migraines are all potential signs of a stroke. Ask the person to walk a short distance. Pay attention to whether they lean more on one side of their body. 
  • Eyes - Check their periphery to find blind spots and ask if they are having difficulty seeing.
  • Face - Ask the person to smile and check for facial asymmetry or drooping of one side of the face. If you are by yourself, smile in the mirror and check if the smile is uneven.
  • Arms - Ask the person if they can feel both their arms to check for numbness. You may also ask the person to raise their arms or bring them forward and observe if there is difficulty doing so on one side. This can also be an easy way to self-check if no one is around.
  • Speech - Ask them to repeat a phrase or sentence. Check for slurred speech or problems in speech comprehension.
  • Time – It is advisable to call 995 immediately when any of these symptoms are present. Treating strokes as soon as possible can reduce health risks and impairment.

The above warning signs and symptoms may manifest hours or even a few days before the impending attack. Do not delay seeking medical care if you notice the signs, even if you still feel like you are fine. There is no time to wait and see when it comes to a stroke. 

BEFAST to Spot a Stroke - B(alance), E(yes), F(ace), A(rms), S(peech), T(ime)

5. Why Time is Crucial During a Stroke

Delayed medical support can leave stroke patients in worse condition and with more severe disabilities. An estimated 1.9 million brain cells die for every minute that a stroke is left untreated. Within the first hour, the brain drastically ages by 3.6 years, which can have detrimental effects for senior adults.

Additionally, patients are only eligible for certain treatment options like tissue plasminogen activator (tPA) within the first few hours of stroke onset. While medical specialists can use alternative procedures, responding quickly to stroke symptoms helps prevent further brain damage and medical complications.

6. The Long-Term Effects of Stroke

Patients and families should be aware of the long-term effects of stroke that may slow down recovery. You may experience:

  • Aphasia (impaired speech comprehension and/or ability)
  • Changes in personality
  • Cognitive impairment
  • Hemiplegia (paralysis on one side of the body)
  • Higher risk of depression
  • Limited mobility
  • Poor memory retention
  • Sensory deficits
  • Visual problems

Fortunately, consistent rehabilitation and proper medical guidance can help stroke survivors improve their conditions over time. 

7. The Recovery Rate of Stroke Patients

Individuals who have suffered from an ischemic stroke have a 31% survival rate and experience around 70% of full recovery within 3-6 months. On the other hand, hemorrhagic stroke survivors have a 24% survival rate and tend to have much slower recovery periods.

Although ageing brains are still capable of self-repair after a stroke, elderly patients are more likely to develop disabilities. Existing health conditions, stroke severity, age, gender as well as motivation and commitment to stroke recovery exercises play a role in an elderly patient’s potential for a full recovery.

8. Recurrent Stroke Prevention

Preventing a second stroke is critical to survival and the quality of life for stroke patients. Research suggests that individuals are at higher risk of experiencing a second stroke within 3 months of the initial stroke. It is important to closely monitor ageing loved ones during this time since a recurrent stroke may lead to more severe brain damage and other medical complications. In general, regular follow-up with your doctor, taking preventive medication as prescribed, and consistent rehabilitation play key parts in the post-stroke care plan. 

Read our stroke rehabilitation guide to know more about post-stroke treatment and care options, and our home care guide for stroke for care tips to help your loved ones recover from a stroke at home.

9. Ninkatec’s Home Care Services for Stroke Patients

As one of the top home care companies in Singapore, Ninkatec provides quality and cost-effective home care services for stroke patients to recover conveniently at home, including: 

  • Nursing care for stroke patients at home
  • Palliative care for stroke in the comfort of your home
  • Physiotherapy, speech therapy and other rehabilitation therapies as required by stroke patients

Our goal is to raise awareness of stroke, help patients cope with their medical conditions at home and relieve the care burden for their families by offering a personalised care plan most suited to their needs: 

  • Virtual Care - For 24/7 virtual support and remote monitoring of clients who experienced a mild stroke.
  • Right at Home - For stroke patients who require minimal living assistance and only need monthly check-ups from a doctor.
  • Close Connect - For patients who have suffered a severe stroke and need extensive living assistance with daily medical supervision.

10. Raise Awareness of Stroke and B.E.F.A.S.T Together

Recognising the earliest signs of a stroke is crucial in preventing severe brain damage. Time is critical when a stroke happens. It can happen any time during any daily life circumstances. For instance, you may notice someone's smile seems to be droopy on one side, or hear someone complain about numbness on just one arm or leg without it being pressed on. By using the B.E. F.A.S.T. method, you can help a stroke victim receive immediate medical attention, decreasing the risk of long-lasting impairments.

Let's spread the words and B.E.F.A.S.T together to prevent the potentially devastating consequences of this disease.


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