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Signs of a stroke before it happens

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Warning signsRisk factorsFASTTreatmentsPreventionSummary
A stroke is a medical emergency that can happen suddenly. Sometimes, signs develop in the hours or days leading up to a stroke. This often includes an intense headache.
Medically reviewed by Megan Soliman, MD
Written by D. M. Pollock
Updated on January 2, 2024

Stroke occurs in two different ways. It can develop when blood flow around parts of your brain becomes blocked by a blood clot or when a sudden bleed starts in one of the blood vessels in your brain.

Strokes due to a blood vessel blockage are called ischemic strokes, which are the most common type of stroke. Ischemic strokes damage parts of your brain as they start to starve your brain cells of the oxygen and nutrients they receive from a healthy blood flow.

Strokes resulting from a bleed in your brain are hemorrhagic. When blood seeps out from a broken blood vessel in areas of your brain, it can place pressure on your brain cells, which causes damage.

Recognizing the early symptoms of a stroke can help you receive treatment faster and improve your chances of a full recovery.

Warning signs of a stroke

An older adult planting seeds in a garden, considering the signs of a stroke before it happens.
SolStock/Getty Images

Often, strokes occur with no warning, making them impossible to predict. But some people may display some warning signs that they may experience a stroke.

As strokes are medical emergencies that need medical intervention immediately, recognizing these signs can help you identify that you may need treatment to prevent a stroke.

According to a study from 2020, the warning symptoms of a stroke can start to develop within 7 days of the stroke event.

Some of these stroke warning signs may include:

Sentinel headaches

If you are at risk of experiencing a stroke, you may want to keep an eye out for unusually severe headaches. These are sentinel headaches. A study of 550 stroke patients notes how nearly 20% of this group noticed sentinel headaches within 1 week before their stroke.

Sentinel headaches can feel unlike other headaches, and you may hear them described as thunderclap headaches. They may include features such as:

  • severe pain
  • pain that spreads horizontally across your forehead
  • pain that does not respond to over-the-counter pain medication
  • pain that may peak within 5 minutes
  • pain that may last for up to 1 hour
  • nausea

A sentinel headache can indicate that you are likely to experience an intracranial aneurysm rupture — this is a bleed in your brain, and it’s one cause of stroke.

If you notice an unusually severe headache, it’s important to take it seriously. It may be an early warning sign that you are going to experience a stroke if you do not receive medical treatment.

Mini strokes

Mini strokes, or transient ischemic attacks (TIA), are another early warning sign that a stroke might occur soon.

A TIA happens when your brain’s blood supply stops for a short period of time. The symptoms of a TIA can mimic a stroke but will typically resolve more quickly.

According to a study from 2021, nearly 30% of people who experience a TIA will go on to experience a stroke. For over 20% of these people, the stroke will happen within 7 days.

Symptoms of a TIA can look like:

  • numbness on one side of your body
  • difficulty with vision
  • difficulty walking
  • dizziness
  • confusion
  • loss of balance or coordination

Risk factors

There are risk factors that affect how likely you are to experience a stroke. Some risk factors you may be able to manage, such as:

Other risk factors you cannot manage, and these often include genetic and environmental factors. These include:

  • age over 65 years (your chance doubles every 10 years after age 55)
  • race and ethnicity (stroke is more common in Black individuals than white individuals)
  • family history of stroke
  • sex (strokes in younger age groups are more likely to occur in men than women)

FAST

When a stroke strikes, every second counts. Recognizing a stroke is essential for making sure you get effective medical treatment to prevent long-term brain damage.

According to the Centers for Disease Control and Prevention (CDC), you can keep an eye out for certain signs and symptoms by remembering the acronym FAST, which means:

  • F: Face. Can you smile, or does one side of your face droop?
  • A: Arms. Can you raise both of your arms at the same time, or does one arm drift down?
  • S: Speech. Can you repeat simple phrases, or does your speech slur or seem strange?
  • T: Time. If you notice the signs of a stroke, you need to act fast and call 911 immediately.

Stroke treatments

As there are two different causes of strokes, ischemic and hemorrhagic, there are different ways of treating them.

Diagnosing the cause is important to determine which method will be the most effective.

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Ischemic stroke

Ischemic strokes occur when arteries in your brain block or narrow. Treatment focuses on freeing the blocking and restoring a healthy blood flow around your brain.

Your doctor will give you medications to break down any blood clots in your brain. These medications will also help prevent more from forming.

These often include aspirin (Ascriptin) and and injection of tissue plasminogen activator (TPA). TPA is very effective at breaking down clots, but you must receive it within 4.5 hours of experiencing symptoms for it to be effective.

Surgery may be necessary. For example, angioplasty is where a surgeon places an inflatable balloon into the blocked vessel. This allows them to insert a mesh tube called a stent to keep the vessel open.

Hemorrhagic stroke

Treatment for a hemorrhagic stroke involves stopping the bleeding, which will help reduce the pressure on your brain. If you are taking blood thinners and experience a stroke, a doctor will use other medications to counteract your blood thinning medications.

However, most often, hemorrhagic strokes require surgery, where the surgeon will repair the structures that are bleeding within your brain.

Sometimes, radiation therapy can help repair the bleed. This is stereotactic radiosurgery and allows the blood to clot.

Prevention

The most effective treatment for stroke is prevention. Preventing a stroke from occurring mainly involves managing the risk factors you are able to.

A key prevention method is blood pressure management. If you have hypertension, this may include following lifestyle recommendations and taking medications as your doctor prescribes. These may include:

Your doctor may also prescribe anticoagulants like warfarin (Coumadin) to thin your blood and prevent clots.

Lifestyle changes you can make to help reduce your chance of stroke include:

  • eating a diet low in saturated fats
  • including plenty of fresh fruit and vegetables in your diet
  • getting enough aerobic exercise daily
  • limiting your salt intake
  • quitting smoking
  • avoiding excessive alcohol

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Summary

There are warning signs that you may be likely to experience a stroke. These mainly include severe sentinel headaches and mini strokes, or TIAs. TIAs may appear like a stroke but will resolve within an hour.

If you notice either of these, you may wish to seek medical treatment for an underlying health concern that is likely to cause strokes. A doctor may recommend an anticoagulant medication or lifestyle factors to help prevent stroke.

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