Warning Stroke: What It Is And Symptoms To Look For

Strokes are a leading cause of death in the US, with nearly 800,000 people experiencing one every year. On average, a stroke occurs every 40 seconds in the country.

These numbers are jarring and scary, especially for folks who have a family history of stroke or who have risk factors like high blood pressure and certain heart conditions.

But you can arm yourself with knowledge to recognize the symptoms of a stroke, understand the risk factors and ultimately help protect yourself from experiencing one altogether. 

According to Dr. Brandon Giglio, the director of vascular neurology at NYU Langone Hospital—Brooklyn, about 85% of strokes in the United States are ischemic strokes, meaning they’re caused by a lack of blood flow to the brain. About 15% are hemorrhagic strokes, which occur when a blood vessel ruptures in the brain.

And among the people who have strokes, many also experience what is known as a warning stroke in the days, weeks or months beforehand.

Here’s what to know about warning strokes:

Warning strokes are known medically as transient ischemic attacks.

Unbeknownst to most people outside of the medical field, warning strokes are a fleeting yet very dangerous medical condition that can be precursors to full-blown strokes.

In fact, up to one in five people who experience a warning stroke could have a stroke within 90 days if they don’t get medical attention, according to Dr. Ahmed Itrat, the stroke medical director at Cleveland Clinic Akron General.

So what exactly is a warning stroke? Medically, it’s referred to as a transient ischemic attack and causes “sudden-onset transient symptoms of neurological injury which resolve on their own,” Itrat said. “These symptoms may be similar to what one would consider a stroke, but the only difference is they don’t lead to a permanent neurological injury.”

In other words, transient ischemic attacks come on quickly, last for a short time, and do not result in the type of brain damage that can be seen with full-fledged strokes.

But the lack of potential brain damage does not mean you should ignore a transient ischemic attack. It’s still a medical condition that needs to be taken seriously, Giglio said. “It really is a harbinger in many people for someone who is going to have a stroke even within the next 48 hours and certainly within the next seven, 30, 90 days,” he said.

Transient ischemic attacks are also commonly referred to as “ministrokes.” But Dr. Joshua Willey, a stroke neurology expert at Columbia University’s Vagelos College of Physicians and Surgeons, said this problematic term minimizes the emergent nature of the condition. The phrase “warning strokes,” on the other hand, highlights that this condition is an emergency, just like a “regular” stroke, he said. 

The signs of transient ischemic attacks and strokes are the same.

“I would say that basically all the same signs and symptoms of a stroke are the signs and symptoms of a transient ischemic attack,” Giglio said.

All three experts who spoke with HuffPost referred to “BE FAST” as a widely accepted mnemonic device detailing the signs of stroke. And as the acronym suggests, these symptoms come on quickly, Giglio said.

Here’s what it means:

• Balance — changes in balance or a loss of balance.
• Eyesight — changes in vision, like blurriness, loss of sight, or double vision.
• Facial droop — drooping of the face or an uneven smile.
• Arm — arm weakness on one side of the body.
• Speech — changes in speech, like slurring words or speaking gibberish.
• Time — it’s time to call emergency services. According to Willey, the “t” can also stand for the terrible headache that comes on fast.

“You could have all of those symptoms, you could have one of those symptoms or any mixture in between,” Giglio said. So, don’t wait around for more than one sign. If you notice any of these issues, go to the emergency room.