A stroke is the leading cause of disability in the Western world and the third most common cause of death. It occurs when the blood supply to a certain part of the brain is interrupted, usually due to a blood clot (ischemic stroke, which accounts for about 85% of cases) or due to a ruptured blood vessel and bleeding (hemorrhagic stroke). The result is the same: The brain cells in the affected area stop receiving oxygen and die.
The good news in 2026 is that the existing treatments – from clot-dissolving drugs (TPA) to advanced brain catheterizations for clot retrieval – are extraordinarily effective. The bad news: They are effective only within a very narrow time window from the moment the signs appear. The responsibility to identify the event lies with you, family members or passersby.
The test that will save lives: F.A.S.T
If a person next to you suddenly behaves strangely, immediately perform the triple test. It takes 10 seconds:
F – Face: Ask the person to smile or show their teeth. Is the smile symmetrical? Is one side of the face drooping, "smeared" or is the eye drooping? Drooping of the corner of the mouth is a bright red warning sign.
A – Arms: Ask the person to close their eyes and extend both arms forward at shoulder height for 10 seconds (like a "sleepwalker"). Does one arm drift downward uncontrollably? Are they unable to lift one arm at all? One-sided weakness is a clear sign.
S – Speech: Ask a simple question ("What is your name?", "What day is it today?"). Is the speech slow and slurred ("heavy speech")? Are they using unrelated words or unable to produce sound? One positive sign is enough to strongly suspect a stroke.
The immediate treatment stage
- Call 101 to MDA immediately: Put the phone on speaker. Emphasize to the dispatcher: "Suspected stroke". This is a code that dispatches an ambulance and prepares the CT team at the hospital even before you arrive.
- Time of symptom onset: Try to remember exactly when it happened ("He was fine at breakfast at 8:00, and at 8:30 we found him like this"). This data is critically important in deciding whether to give a clot-dissolving drug.
- Positioning and rest: Sit or lay the person down in a comfortable position, with the head slightly elevated (about 30 degrees) to reduce intracranial pressure, but without creating airway obstruction.
- Reassurance: A stroke is a very stressful event for the person, who may sometimes understand what is happening but cannot communicate. Speak to them calmly.
Common mistakes (and what not to do)
Do not give aspirin! Unlike a heart attack, in a stroke we do not know whether it is a blockage (clot) or a rupture (bleeding). If it is a hemorrhagic stroke, aspirin will worsen the bleeding and may kill.
Do not let them "sleep it off"! Sudden fatigue is a sign of stroke. If the person goes to sleep, they may wake up with permanent damage that can no longer be treated because the "window of opportunity" has closed.
Do not give food or drink. The swallowing mechanism is often impaired in a stroke, and giving water may cause choking and pneumonia.