The hospitalization of Connecticut U.S. Sen. Chris Murphy after a stroke is renewing attention to the importance of recognizing stroke symptoms and getting medical help quickly.
Murphy, 53, reportedly noticed numbness in his arm while attending his son's hockey game and received medical attention. Dr. Rachel Forman, a stroke specialist with Yale New Haven Health, said sudden numbness, weakness or other neurological symptoms should never be ignored, even if they disappear.
“If someone has sudden onset of numbness on one side of their body that can be a sign of stroke, and it's really important to get to the hospital as soon as possible,” Forman said.
Remembering the signs of stroke
Forman said a useful way to remember stroke warning signs is the acronym FAST: face, arm, speech and time.
That means looking for facial drooping or numbness, weakness or numbness in an arm or leg, and difficulty speaking or understanding speech. The final letter is a reminder that time matters: Anyone experiencing those symptoms should call 911.
Forman said people sometimes dismiss symptoms that come and go, but that can be dangerous.
A transient ischemic attack, or TIA, is sometimes called a warning stroke. While its symptoms may resolve, Forman said it should be taken just as seriously as a stroke.
“Sometimes people will say mild or mini stroke, but I don't like to minimize a TIA because, as you said, it oftentimes could be a warning for another stroke that's larger coming,” she said. “We take both of them just as seriously, a TIA or a stroke itself.”
Strokes are increasingly affecting younger people
Forman said doctors are seeing more strokes among younger people, in part because risk factors such as high blood pressure, diabetes, physical inactivity, sleep apnea and high cholesterol are becoming more prevalent.
High blood pressure is particularly important because it often produces no noticeable symptoms.
“That's why it's called the silent killer, because oftentimes the first time people know they're having high blood pressure is when they come in with a devastating stroke,” Forman said.
She encouraged people to know their blood pressure numbers and work with their health care providers to keep risk factors under control.
But Forman cautioned against assuming that a person who has a stroke necessarily has high blood pressure or another traditional risk factor. Clotting disorders and genetic predispositions can also contribute.
Diagnosing transient symptoms can be difficult
Not every episode involving stroke-like symptoms turns out to be a stroke. Forman said diagnosing patients can be challenging when symptoms disappear and imaging does not show a blocked artery.
In those cases, neurologists consider the patient's symptoms, medical history, age and risk factors to determine whether the episode was a TIA, a migraine or something else.
Forman said a negative scan does not necessarily mean a person should dismiss what happened. The evaluation and diagnosis need to take the full clinical picture into account.
Lifestyle changes should be realistic and individualized
Forman said diet can play an important role in stroke prevention, but recommendations should reflect each person's health needs, circumstances and resources.
She pointed to the Mediterranean-style diet, which emphasizes fruits and vegetables and limits less nutritious foods. She also said some people experience headaches after eating particular foods, including salty foods, chocolate or drinking wine. Those potential triggers are individual and worth discussing with a health care professional.
Stress is another area where researchers are learning more about possible connections to stroke. Forman said doctors do not simply attribute a stroke to stress. Instead, they look for the ways stress might affect the body, including raising blood pressure or triggering an abnormal heart rhythm.
Forman also encouraged people to find realistic ways to stay active, even if traditional exercise is not practical. She cited Stroke OT, a Connecticut-based stroke support group that offers free online exercise classes for stroke survivors.
The broader message, she said, is that people do not have to figure out prevention on their own. Health care professionals can help develop practical plans for diet, exercise and managing risk factors.
