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Stroke - Symptom

Alternative Names

Cerebrovascular disease; CVA; Cerebral infarction; Cerebral hemorrhage; Ischemic stroke; Stroke - ischemic; Cerebrovascular accident; Stroke - hemorrhagic

Symptoms:

The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not know that he or she has had a stroke.

Symptoms usually develop suddenly and without warning. Or, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.

A headache may occur, especially if the stroke is caused by bleeding in the brain. The headache:

  • Starts suddenly and may be severe
  • Occurs when you are lying flat
  • Wakes you up from sleep
  • Gets worse when you change positions or when you bend, strain, or cough

Other symptoms depend on how severe the stroke is and what part of the brain is affected. Symptoms may include:

  • Change in alertness (including sleepiness, unconsciousness, and coma)
  • Changes in hearing
  • Changes in taste
  • Changes that affect touch and the ability to feel pain, pressure, or different temperatures
  • Clumsiness
  • Confusion or loss of memory
  • Difficulty swallowing
  • Difficulty writing or reading
  • Dizziness or abnormal feeling of movement (vertigo)
  • Lack of control over the bladder or bowels
  • Loss of balance
  • Loss of coordination
  • Muscle weakness in the face, arm, or leg (usually just on one side)
  • Numbness or tingling on one side of the body
  • Personality, mood, or emotional changes
  • Problems with eyesight, including decreased vision, double vision, or total loss of vision
  • Trouble speaking or understanding others who are speaking
  • Trouble walking

Signs and tests:

A complete exam should be done. Your doctor will:

  • Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or improving.
  • Listen for an abnormal sound, called a "bruit," when using a stethoscope to listen to the carotid arteries in the neck. A bruit is caused by abnormal blood flow.
  • Check your blood pressure, which may be high.

Tests can help your doctor find the type, location, and cause of the stroke and rule out other disorders.

Other tests include:

  • Reviewed last on: 6/24/2011
  • Reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Latchaw RE, Alberts MJ, Lev MH, Connors JJ, Harbaugh RE, Higashida RT, et al. Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association. Stroke. 2009;40:3646-3678. Epub 2009 Sep 24.

Del Zoppo GJ, Saver JL, Jauch EC, Adams HP Jr: American Heart Association Stroke Council, Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: a science advisory from the American Heart Association/American Stroke Association. Stroke. 2009;40:2945-2948. Epub 2009 May 28.

Chung CS, Caplan LR. Stroke and other neurovascular disorders. In: Goetz, CG, eds. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 45.

Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:227-276.

Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:517-584.

Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, Broderick JP, Connolly ES Jr, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;41:2108-2129.

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