I’m a doctor — don’t delay care if you experience these stroke symptoms

If you saw someone having a stroke, would you be able to recognize it? What if you were having one yourself?

If you can’t name any of the signs and symptoms of a stroke , you’re not alone. In fact, raising stroke awareness is one of Dr. Brandon Giglio’s top priorities.

We spoke with Giglio, a vascular neurologist for NYU Langone’s Comprehensive Stroke Center, about the signs and symptoms everyone should know — and no one should ignore.

We’ve all probably heard the word “stroke,” but what exactly is a stroke? What’s happening in the brain?

A stroke essentially is when a part of the brain is damaged. And, most commonly, that’s due to a lack of blood flow.

The majority of strokes are what’s called an ischemic stroke. That accounts for about 85% of strokes and means there’s a blockage in an artery or inadequate blood flow through that artery that leads to an area of the brain becoming damaged.

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The other 15% of the time, the strokes are a hemorrhagic stroke where the brain tissue becomes damaged secondary to bleeding within the brain.

When we think about strokes, many might think of it as an older person’s problem. Are there things young people need to be aware of when it comes to strokes?

My team and I are constantly trying to raise awareness because this is one of the biggest misconceptions: People think it’s only a disease of the elderly — which is false. Young people can also experience a stroke.

Speaking of young people, a couple of years ago, Justin Bieber’s wife, Hailey Bieber, had a mini stroke. How is a mini stroke different from other stroke types?

I think the term “mini stroke” really does a disservice to the seriousness.

The main difference between a mini stroke, or transient ischemic attack (also called TIA), and a stroke is whether your brain was actually, in fact, damaged or not. With a stroke, part of the brain was damaged. With TIA, or mini stroke, you had the same signs and symptoms, the same processes that cause a stroke, but the body was able to reverse that immediate lack of blood flow before permanent brain damage occurred. In fact, stroke symptoms can be transient, and you may still have suffered brain damage.

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The risk of stroke is significantly greater after people have experienced TIA. A stroke could happen within days after TIA. And that’s why it’s important that even someone who has transient or temporary symptoms should still go to the emergency room.

Let’s talk about some of those signs and symptoms. Many people might think of the drooping of your face. Are there other signs and symptoms that people don’t know?

The American Heart Association has put forth this acronym called BE FAST. The notion is that if you get any of these signs and symptoms, be fast and call 911.

• B is for balance — difficulty with walking
• E is for eyesight — seeing double vision, blurred vision, loss of vision
• F is for a facial droop or crooked smile
• A stands for arm weakness or numbness. This also applies for leg weakness or numbness.
• S is for changes with speech
• T represents time — time to call 911

Having just one of these signs and symptoms, if it starts abruptly, could indicate someone is experiencing a stroke.

Other than age, what are some risk factors for stroke? And what can people do to minimize their risk?

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Independent of age, the most common reason someone has a stroke is largely related to cardiovascular risk factors — which can all be managed with medications and lifestyle changes. And these are things such as high blood pressure, high cholesterol, diabetes, smoking, lack of physical activity and diet. There are other causes, but the majority of strokes are related to someone having those risk factors and not having them properly controlled.

New Yorkers are strong — maybe they think they can “tough it out” if they’re not feeling well. Is there anything New Yorkers should be aware of when it comes to stroke?

I’m a lifelong New Yorker. I grew up in Staten Island.

But if you had any of the signs or symptoms of stroke captured in that acronym BE FAST, you should go to the emergency room, be evaluated, get the right treatment and try to figure out why this happened.

Your symptoms might be temporary and now you’re feeling 100% normal. You might get all your testing done and go home within the same day, but you will get started on treatment right away, which can reduce your risk that in the next week you’re going to have a stroke again. The long-term plan is to reduce your risk as best as we can so that you don’t have another stroke, and you don’t end up with a severe disability.

Right now 800,000 Americans have a stroke each year, and for about 20% of them, it’s not their first stroke. It’s a recurrent stroke. This is why there’s such a need for more stroke awareness and more counseling on how people can reduce their risk.

This interview has been edited for length and clarity.

Brandon Giglio, MD , is the director of vascular neurology at NYU Langone Hospital — Brooklyn and a clinical assistant professor at the Department of Neurology at NYU Grossman School of Medicine. He specializes in vascular neurology, including stroke, brain aneurysm and carotid artery disease.

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