Subtle Signs You Are Having a Stroke

Symptoms of a stroke may be dramatic — the inability to move, see, or speak — but they might also be subtle or non-visible to an onlooker or medical professionals. Subtle signs of a stroke may include dizziness, nausea, or numbness. A stroke occurs when oxygen-carrying blood is prohibited from getting to a part or parts of the brain. The inability to get oxygen to the affected part of the brain causes brain damage. Brain damage is just one of the effects of stroke on the body. Stroke-affected systems may include:

  • Respiratory;
  • Nervous;
  • Circulatory;
  • Muscular;
  • Digestive;
  • Urinary;
  • Reproductive.

Stroke statistics show that approximately 795,000 people suffer a stroke each year in the U.S., 600,000 as first-time attacks, and 185,000 as recurrent strokes. Strokes are the third-leading cause of death in the U.S., with more than 140,000 deaths annually. In addition, strokes are also the leading cause of serious, long-term disability.

The severity of these conditions makes understanding what types of strokes there are — and recognizing the symptoms from obvious to subtle — important for the American population. It’s even more pertinent than most realize, especially considering that though nearly 25% of strokes occur in those over 65, strokes may occur at any age. Additionally, during a stroke, even seconds count, and a shortage of healthcare providers can lead to deadly delays in treatment. While an increased demand for healthcare workers has driven more nurses to attain certification, there are still steps you can take to prevent and respond to strokes.

Types of Strokes

Symptoms of strokes may vary depending on the type of stroke you are having. Awareness of stroke warning signs and symptoms as well as different types of strokes can help patients seek out critical care and treatment as quickly as possible. Patients who receive care in the first three hours of showing symptoms often experience fewer instances of disability in the following three months after the stroke, as opposed to those that received delayed care.  

Ischemic Stroke

Ischemic strokes account for roughly 87% of all strokes; they occur when a vessel supplying oxygenated blood to the brain is obstructed. Obstructions typically occur from fatty deposits that line vessel walls. There are two types of obstructions. The first, cerebral thrombosis, is a clot that develops at a fatty plaque deposit within a blood vessel. Cerebral embolism is a blood clot that forms in the circulatory system — the heart or larger arteries of the upper chest and neck — which then dislodges and travels through the bloodstream. It continues until it reaches blood vessels in the brain that are too small to let it pass, effectively clogging the vessel. High cholesterol and blood pressure typically contribute to ischemic strokes.

Hemorrhagic Stroke

Hemorrhagic strokes account for roughly 13% of all strokes and are caused by a weakened vessel that ruptures and bleeds into the surrounding brain tissue. As the blood accumulates, it compresses the surrounding brain tissue. The two types of hemorrhagic strokes include intracerebral hemorrhage (a ruptured blood vessel in the brain) and subarachnoid hemorrhage (a ruptured blood vessel just outside of the brain). High blood pressure typically contributes to hemorrhagic strokes and may increase the chance of aneurysms and strokes in arteriovenous malformations (AVM) — congenital malformed blood vessels in the brain.

Uncommon Stroke Symptoms

Though there are major symptoms that are more easily observable such as difficulty speaking, weak limbs, fainting or loss of consciousness, there are other more subtle symptoms. The less dramatic and more uncommonly reported symptoms may include:

  • Nausea and/or vomiting;
  • Dizziness;
  • Numbness
  • Loss of balance or an unsteady gait;
  • Weakness in the face (telltale by a drooping lip or eyelid);
  • Slurred speech;
  • Headache.

Symptoms Unique to Women

Women have a higher risk of stroke, have more strokes than men, and experience more stroke fatalities than men. Women may be at higher risk due to pregnancy, preeclampsia (high blood pressure that develops during pregnancy), birth control, hormone replacement therapy, migraines with aura, and atrial fibrillation — many of these risks are increased with smoking. All told, one in five women will experience a stroke.

Symptoms reported by women that are non-traditional may include:

  • Fainting or loss of consciousness;
  • General weakness;
  • Shortness of breath or difficulty breathing;
  • Disorientation, confusion, or unresponsiveness;
  • Sudden behavioral changes;
  • Agitation;
  • Hallucination;
  • Nausea and/or vomiting;
  • Pain;
  • Seizures;
  • Hiccups.

Sex differences in the evaluation and treatment of stroke may cause stroke symptoms to go unrecognized or misdiagnosed. Lack of proper diagnosis may lead to inappropriate triage and detrimental/fatal delays in treatment, making the awareness, recognition, and understanding of the possible differences in stroke symptoms imperative. Hopefully, as more aspiring caregivers go to accredited schools and receive training on communication with patients, as well as advanced training that will allow them to recognize women’s stroke symptoms, more women suffering from stroke will get the essential treatment they need in the time they need it.

What to Do In Case of a Stroke

Recognizing and identifying the signs of a stroke can help get stroke victims the triage care they need as quickly as possible. Rapid access to medical professionals may be difficult in rural areas or areas experiencing health professional shortages. Utilizing the FAST acronym can help families to identify the signs of a stroke and seek immediate access to the closest medical professional. FAST stands for: face, arm, speech, and time.


Look for signs of facial drooping. Ask the stroke victim to smile and look for any recognizable sections of the face that may droop.


Arm weakness may be a sign of stroke. Ask the stroke victim to raise both arms to see if one is weaker or sags.


The inability to speak properly is a recognizable sign of stroke. Ask the stroke victim to say or repeat a simple phrase. Listen for difficulty producing speech. This may sound like slurred or strange-sounding words


Time is the most important factor in stroke treatment and recovery. If a stroke victim displays any of the above symptoms, call 911 and seek immediate emergency services.

How to Prevent a Stroke

There are some risk factors that cannot be reduced through lifestyle changes such as:

  • Age;
  • Sex;
  • Race;
  • Family history of stroke.

However, there are many treatable risk factors and ways to help prevent stroke, such as:

  • Controlling high blood pressure or hypertension with a strategy from your doctor which helps to bring your blood pressure to a normal range. This may include maintaining a healthy weight, eating correctly, and physical exercise. This may also include avoiding drugs that may raise blood pressure, or taking medicine that lowers blood pressure.
  • Avoid smoking cigarettes. Cigarettes are linked to the build-up of fatty substances in the carotid artery. They also increase blood pressure, and blood thickness.
  • Managing common heart disorders and heart disease. This may include aspirin or other blood-thinning therapy.
  • Seeking immediate medical attention from warning signs or a history of transient ischemic attack (TIA). Experiencing a TIA or stroke increases your chance of having a second stroke.
  • Managing proper levels of cholesterol. Cholesterol excess can build up in blood vessels, increasing the change of both heart attack and stroke.

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