Stroke (Apoplex): Recognize the symptoms and signs

Stroke (stroke) is a disease that occurs suddenly and can sometimes have serious consequences. A stroke is caused either by blockage of the blood vessels that normally supply blood to the brain (ischemic stroke) or by bleeding in the brain (hemorrhagic stroke). Depending on which area of ​​the brain is affected by a blood vessel blockage or cerebral hemorrhage, a stroke can manifest itself with different symptoms. But what does a stroke look like? In this gallery, you will learn how to recognize a stroke and what a simple test you can do if you suspect that someone is showing signs of a stroke.

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Hemiplegia as a typical symptom of stroke


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A typical symptom of a stroke is hemiplegia. Usually, sufferers are unable to move their arm and/or leg on one side of the body, or only to a limited extent. Like all stroke symptoms, this restriction of movement usually occurs suddenly. This means that poor leg movement that develops over weeks is not typical of stroke, for example.



Hanging corners of the mouth as the first sign of a stroke

A man with a hanging corner of the mouth as a symptom of stroke
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Not only the arms and legs can be affected by unilateral paralysis. Half of the face is often paralyzed. The forehead can still be wrinkled on both sides, but there are difficulties in puffing out the cheeks or making a kissable mouth. This so-called “weakness in the mouth” can also be seen by the fact that when the sufferer drinks, the drink comes out of the corner of the mouth on one side because he is paralyzed.



Sensory disturbances on one side of the body

Test for sensory disturbances in the hands
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Not only can the ability to move on one side of the body be lost, but often there are also disturbances in the sense of touch. Affected people feel that touching one side of the body is weaker than the other side or not at all. If movement disturbances occur at the same time, these disturbances and sensory disturbances in the case of a stroke are usually found on the same side of the body.

Touch sensation can be assessed by striking both arms and legs at the same time and asking the affected person whether they feel touch equally on both sides.



Speech disturbances as signs of a stroke

A man suffering from speech disorders as symptoms of a stroke
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Speech disturbances can also indicate a stroke: for example, a person who does not usually have problems speaking may suddenly speak only slowly, hesitantly, and with great difficulty in the morning, even though they could have spoken normally the night before. A stroke can also manifest as sudden problems with speaking.

If the symptoms, as in this example, occur immediately after waking up, then one also speaks of a “stroke”. In about one in five cases, symptoms are noticeable upon waking in the morning. In general, all the signs presented here can appear not only suddenly during the day, but also immediately after waking up.



Poor language comprehension as symptoms

woman with language impairment
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Not only the pronunciation of words, but also the content of what is said can suddenly change in the event of a stroke. Then the affected people talk a lot and very quickly, for example, but what they say makes no sense. If you ask them questions, they answer them, but not purposefully. For example, you can ask the aggrieved person their name and they will confidently give an inappropriate answer such as “8 August”.



word search disorders

Woman experiences difficulty finding words as a symptom of stroke
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In addition to stumbling speech and limited understanding of language, sufferers often have difficulty finding words. For example, if you hold a pen and ask them to name the thing, the answer might be “the thing you can write with.” However, they cannot find the appropriate term for the object.



Visual disturbances and double vision as signs

A woman with blurred vision as a symptom of a stroke
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If the posterior region of the brain is affected by a stroke, then visual disturbances are very common. This can be manifested, for example, in the fact that the entire left half of the field of view can no longer be seen with both eyes. Double vision can also occur.

Because some parts of the field of view are lost, some affected also describe, for example, that they are suddenly no longer able to correctly judge distances to objects such as the fork in their hand or the plate on the table.

However, not all visual disturbances necessarily indicate a stroke: flickering before the eye can also be present with subsequent headaches, especially in young people or those with a history of headaches, the so-called migraine aura. In older adults who experienced migraines in their youth, headaches that follow eye twitching may not occur. On the other hand, flashes in the eyes are more likely to indicate retinal damage than a stroke and require an ophthalmologist consultation as directly as possible.



Dizziness in stroke

A man suffers from dizziness as a symptom of a stroke
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A stroke can also present with sudden dizziness, often accompanied by an unsteady gait. Affected people often report what’s called “vertigo,” which feels like they’re on board a ship swinging on the high seas. However, ‘turning vertigo’ can also occur, in which sufferers feel as if they are riding in a circle.

In addition to the listed signs, nonspecific symptoms such as headache, nausea and vomiting can occur in the event of a stroke. In some cases, a stroke can portend hearing loss or tinnitus – a Canadian study provides the first indications of this.



Quick Diagram as a Test – Recognize Stroke

A man approaches a woman with stroke symptoms
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In principle, a stroke in a woman is no different from the symptoms of a stroke in a man, so the signs apply to both sexes. All of the symptoms mentioned can be summed up in a simple chart that even ordinary people can follow to recognize the signs of a stroke.

With the FAST chart, you can quickly and easily test for possible stroke symptoms:

  • F stands for “face” (the face in English)
  • A “weapons”
  • S for “Speech” (English speaking)
  • T stands for “time”


F stands for “face” – face

Woman showing stroke symptoms on her face
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Encourage the casualty to laugh while showing his teeth. In the case of a stroke, as a result of paralysis, one corner of the mouth often hangs lower than the other when smiling, or there is a slight disparity between the two halves of the face when smiling in the mouth area. For example, only the nasolabial fold (nasolabial fold), which usually appears at the junction with the cheeks when smiling, can be less noticeable on one side.

You can also ask the person to puff out their cheeks and hold their lips to assess mirror image equivalence between the two halves of their faces. “Putting out your tongue” is also a possible test for stroke: if the tongue tilts to one side when held on or cannot be moved in both directions (right and left), this is also a possible sign of disease.



A “weapons”.

Nurse tests arms for symptoms of stroke
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Ask the affected person to extend their arms forward, hands palms up, as if the person was holding a tray. Then she should close her eyes and hold this position for 30 seconds. During the stroke, the palm does not remain on one side extended upwards, but instead rotates the hand inward or until the arm is fully relaxed. In some cases, it is not even possible to raise the arm in order to try. If you were to raise a person’s arm in such a situation, they might fall straight down without any force.

You can also test the same on your legs. The person lying down should raise their legs parallel to a right angle and hold them in the air with their eyes closed. A stroke can cause one leg to sag or not even lift.



S stands for “speak” – to speak

A woman's speech test in a stroke patient
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Have the person repeat a simple sentence, such as “Dear Lily Lehmann” or even easier, “Today is a beautiful day.” You can also let the person name something. For example, grab a pen or your watch and ask the person to name the thing. In the event of a stroke, the other person may answer your questions too slowly, stuttering, uncertain, not in spirit, or may not follow your prompts appropriately.



T stands for “time” – time

A woman calls an ambulance for a man who has a stroke
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The letter T stands for time and therefore is a very important point. If any of the above exercises show an abnormality, call the emergency number (112) immediately. The sooner the affected person gets to the emergency room, the better the chances of treating their symptoms.



Malignant stroke: symptoms

A woman with stroke symptoms at the doctor
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A malignant stroke refers to a short-term disturbance of the blood circulation in the brain (transient ischemic attack, TIA). In this case, the same symptoms that we have already mentioned can suddenly occur. However, these subside within minutes to hours.

However, a TIA is a precursor to stroke and the risk of a “real” stroke is highest in the first 24 to 48 hours after the event. Therefore, even if the symptoms disappear after a few minutes, you should definitely go to the emergency room if this is the case.

ICD codes for this disease: I64, I63.-

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