Stroke: Act FAST

May 30, 2013

May is Stroke Awareness Month, and I’d like to take this opportunity to make sure our readers know some of the basic facts about stroke, and give them some resources to consult if they want to know more. Many of you know most of what follows, but some may well be new, and reviewing important information is never a bad idea.

Stroke is quite prevalent in the United States, and is expected to increase (both in prevalence and in costs) over the next two decades. Currently, almost 800,000 people in the United States suffer a stroke each year, and there are an estimated 7 million stroke survivors. Stroke kills approximately 133,000 Americans each year, making it the third leading cause of death.

That means one person suffers a stroke every 40 seconds, and every four minutes someone dies from a stroke. There is an even higher incidence of stroke in minority communities, and African Americans are more likely than Caucasians to die from a stroke, and African American survivors are more likely to suffer severe physical impairments.

So, what can we do about this? Both the American Stroke Association (ASA, and National Stroke Association (NSA, are good education and advocacy groups. They both do impressive work advancing the interests of stroke survivors, and providing useful information about preventing and recovering from stroke.

We can have more of an impact, however, on our lives and those of our friends and families. If there’s one thing we can learn, or teach others this Stroke Awareness Month, it’s the warning signs of an acute stroke. Both the NSA and ASA are promoting the acronym FAST for stroke warning signs. The most important signs are:

FACE DROOPING — Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
ARM WEAKNESS — Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
SPEECH DIFFICULTY — Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
TIME TO CALL 9-1-1 — If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared.

There are some other stroke warning signs one should know as well.
• Sudden numbness or weakness of the leg
• Sudden confusion or trouble understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

Why is it so important to know these warning signs, and to act quickly if you recognize them in someone? Because “time is brain.” The most effective treatment for acute stroke is more effective if it is given early. In fact, it’s generally thought to have little or no benefit if it’s given more than 3 hours (in some cases, 4.5 hours) after the beginning of symptoms. This drug, called tissue plasminogen activator (TPA), is also quite effective – if given in the first three hours, 25% more patients will have a very good outcome when measured 3 months after the stroke. Even within the first 3 hours, the earlier the treatment, the better the odds of a good recovery.

So learn these signs, and act quickly to get medical attention for someone who may be having a stroke. If you have an iPhone or Android phone, you can download the “Spot a Stroke FAST” app from iTunes ( or Google Play (

With some luck, you’ll never have the need to use this information, but you never know – the brain you save might well be your own!

Jason Greenberg, MD
Director Stroke Rehabilitation Services