Recognizing stroke early
Early treatment of the most common type of stroke, ischemic stroke,
can limit brain damage and vastly improve outcomes. Ischemic stroke
is the kind caused by atherosclerosis, which causes blood clots that
block the blood supply to a part of the brain. Yet some research suggests
that fewer than 10% of ischemic stroke patients receive important clot-busting
drugs, which are most effective when given within three hours after
symptoms start. Patients often arrive at the hospital after that window
of opportunity has closed. They delay getting treatment because stroke
symptoms may not be that pronounced or they are mistaken as coming
from other, less serious problems.
As a result, doctors are looking for ways to make it easier for the
layperson to identify a stroke. The Cincinnati Prehospital Stroke Scale
is one such attempt. Some experts say it leaves out too many symptoms.
Others say it will cause false alarms because it’s not specific
Even so, the Cincinnati scale is a beginning. In one study, if any of
the three tests that are part of the scale were abnormal, the chances
that the person had suffered a stroke were about 70%.
Cincinnati prehospital stroke scale
- Crooked smile. Have the person smile or show his or her teeth.
If one side doesn’t move as well as the other so it seems to
droop, it could be a sign of a stroke.
- Arm drift. Have the person close his or her eyes and hold his or
her arms straight out in front for about 10 seconds. If one arm does
not move, or one arm winds up drifting down more than the other, that
could be a sign of a stroke.
- Slurred speech. Have the person say, “You can’t teach
an old dog new tricks,” or some other simple, familiar saying.
If the person slurs the words, gets some words wrong, or is unable
to speak, that could be a sign of a stroke.
May 2006 update
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