Watch Out For These Uncommon Warning Signs Of Stroke

Stroke is a serious neurological condition causing significant morbidity and mortality. It was declared as global health emergency by WHO in 2010. Annually 15 million people suffer from stroke and 5.5 million people die. In India annually more than 13.5 lakh people suffer from stroke, every forty seconds one patient is suffering from stroke and a patient dies every four minutes.  

Stroke has a time sensitive treatment and to identify the stroke symptoms, know the acronym BE-FAST and save lives. 

B balance 

E eye signs 

F facial weakness 

A arm weakness 

S speech difficulty 

T time to act fast

However there are many other warning signs in a stroke patient. Transient ischemic attacks are a form of mini strokes were in patient develops above symptoms and completely recovers in few minutes to few hours 10 per cent of them develop full fledged stroke and next three months and half of them develop stroke in next 48 hours if not evaluated and treated. This episodes should be worked up and appropriate treatment planning has to be done by the neurologist.

 Seizures can occur as a presentation of stroke in some patients. Patients can have sudden onset memory loss and  loss of visual special orientation and lose the way if brain areas controlling memory and navigation system are affected. 

Some patients may present with coma if they develop massive bleeding in the brain or a clot in the brain stem. 

Loss of sensation in one part of the body sudden on set blindness difficulty in reading and writing may also occur in patients with acute stroke.

New onset behavioural disturbance and inappropriate emotions may also manifest in patients with acute stroke. 

Stroke, unlike heart attack is a painless condition. Most patients 10 to ignore the symptoms and considered as a part of generalised weakness, low sugar, BP fluctuations and other medical issues. Awareness is the key. 

"Kaantara stroke"

80 year old gentleman came to neurologist for check up. His left hand was shaking since one day. Upon enquiry, his daughter revealed, " Sir, yesterday evening we went to kantaara movie. Since then his left hand started shaking. We thought he has been emotionally connected to the movie and waited for it to settle down. As it didn't improve for 24 hours we came to you for further evaluation". Neurologist examined carefully and suspected stroke as his blood pressure was high and patient had chorieform movements (involuntary movements). MRI brain revealed a stroke in right basal ganglia which was corresponding to his clinical symptoms. He was started on treatment and improved in few days. This is a rare , yet treatable condition causing stroke.

Dr. (Prof.)Suryanarayana Sharma P M

Guest Author Senior consultant neurologist and stroke specialist Apollo hospitals Bannerghatta Road Bangalore