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Early symptoms of stroke may be missed

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Most people do not recognise the early warning symptoms of stroke, which could cause a delay in treatment. Part of the problem is that stroke symptoms can vary, so the general public does not find it easy to recognise the early signs of stroke.A stroke or “brain attack” occurs when the vessels supplying blood to the brain are blocked, interrupting the blood flow. This results in the death of the brain cells. Depending on the area of the brain involved and the extent of brain cell death, specific body functions such as speech, movement, memory etc. may be affected.The researchers at the University of Newcastle in New South Wales, Australia based their findings on discussions conducted in Australia in which 35 people participated: 14 people who had experienced a stroke, 11 from the general public with no personal experience with stroke, and 10 partners of stroke patients.Descriptions of symptoms by stroke survivors differed from descriptions by members of the general public group who only identify the "textbook" symptoms of stroke, such as tingling, paralysis or loss of vision, particularly on one side of the body. Some stroke survivors did not initially understand they were having a stroke because their symptoms differed from those they knew about. Stroke symptoms can include:
  • headache
  • nausea and vomiting
  • vertigo (which is a feeling of dizziness or a sense the world is reeling)
  • emotional incontinence; easily laughing and crying
  • speech sounds like a bird or as if drunk
  • strange taste in the mouth
  • sudden numbness or weakness of the face, arm or leg
  • balance problems, double vision or light-headedness
Stroke patients who participated in the study did not take their symptoms seriously because they thought their symptoms would disappear. Some did not identify their experience as stroke because the symptoms did not present as expected. Participants who had no direct experience with stroke did not know much about stroke organizations or educational materials, and they expected to learn about stroke through their doctor, or community-based education efforts. The symptoms of stroke are not easy to recognise because they vary a lot. Presentation of information about stroke by hospital and community health services needs to be improved. Simple and understandable educational materials should be developed and their effectiveness monitored. Community education efforts should focus on informing people at high risk, such as the elderly and people with high blood pressure, about stroke's early warning symptoms.
BMJ May 2002, Vol. 324(7345)

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