World Stroke Day 2026: How to recognise a stroke and what to do immediately

On World Stroke Day, observed on October 29, the message is simple: recognising a stroke early and reaching the right hospital without delay can save brain cells, prevent disability and save lives.

Imagine a person suddenly unable to speak clearly. One side of the face droops, and an arm becomes weak. The family assumes it is exhaustion, offers water, calls a relative or waits to see whether the symptoms improve. Precious time passes. This delay can change the course of a person's life.

Stroke is a medical emergency in which blood supply to part of the brain is interrupted, either by a blocked blood vessel or bleeding into the brain. It remains a leading cause of death and long-term disability worldwide. One in four adults will experience a stroke during their lifetime. India carries a substantial burden, with hypertension, diabetes, tobacco use and other modifiable risk factors contributing to many cases.

The encouraging news is that stroke is often treatable, and many strokes are preventable. The difference frequently lies in how quickly we act.

Why every minute counts

The brain depends on a continuous supply of oxygen and glucose. When a blood vessel is blocked, brain cells begin to malfunction and die. The longer the interruption continues, the greater the potential damage. In a major ischaemic stroke, nearly two million neurons may be lost every minute without effective blood flow restoration. This estimate illustrates the urgency, although the rate of injury varies considerably between patients.

Time also determines access to treatment. Most patients with ischaemic stroke can receive clot-dissolving medicines within 4.5 hours of symptom onset. Mechanical thrombectomy, a procedure to remove a clot from a large brain artery, can benefit appropriately selected patients up to 24 hours after they were last known to be well.

Earlier treatment generally produces better outcomes. Do not spend time waiting for symptoms to disappear or searching for home remedies.

Recognize a stroke: Think BE-FAST

Stroke symptoms usually begin suddenly. Remember BE-FAST:

• B - Balance: Sudden loss of balance, coordination or difficulty walking.

• E - Eyes: Sudden loss of vision, double vision or other abrupt visual disturbance.

• F - Face: One side of the face droops when the person smiles.

• A - Arm: Sudden weakness or numbness, particularly on one side of the body.

• S - Speech: Slurred speech, difficulty finding words or inability to understand others.

• T - Time: Call emergency services immediately.

Other warning signs include sudden numbness on one side, confusion, difficulty swallowing or an abrupt, unusually severe headache, particularly with vomiting or altered consciousness.

Symptoms that disappear after a few minutes may represent a transient ischaemic attack (TIA), sometimes called a mini-stroke. A TIA is a warning of possible future stroke and requires urgent medical evaluation even if the person feels completely normal afterwards.

What should you do if stroke is suspected?

Call an ambulance and arrange immediate transfer to a hospital equipped to evaluate and treat stroke. Note the exact time symptoms began, or when the person was last seen normal. This information helps doctors determine treatment eligibility.

Do not give food, water or oral medicines because swallowing may be impaired. Do not give aspirin on your own: a brain scan must first distinguish a blocked artery from bleeding. Avoid unproven remedies, including attempts to lower blood pressure rapidly at home.

Do not wait for a family doctor or routine appointment. If ambulance services are unavailable, arrange the fastest safe transport to an appropriate emergency department.

Modern stroke treatment

The first step is urgent brain imaging, usually a non-contrast CT scan, to identify bleeding and guide treatment. CT angiography or other advanced imaging may identify blocked large arteries and help select patients for additional treatment.

There are two major types of strokes, and treatment differs.

Ischaemic stroke: This accounts for most strokes and occurs when a clot blocks an artery supplying the brain.

Eligible patients may receive intravenous thrombolysis (clot-dissolving treatment with medicines such as alteplase or Tenecteplase) generally within 4.5 hours of symptom onset. In selected patients with unknown onset or later presentation, advanced imaging may identify salvageable brain tissue and support treatment beyond the conventional window.

For certain large-vessel blockages, mechanical thrombectomy involves guiding a catheter through an artery to remove the clot. It can dramatically improve outcomes in appropriately selected patients, including some presenting up to 24 hours after they were last known well.

Haemorrhagic stroke: This results from bleeding into or around the brain. Treatment may include carefully controlled blood pressure reduction, reversal of anticoagulant medicines when indicated, management of raised pressure within the skull and, in selected cases, neurosurgery or endovascular procedures.

A dedicated stroke unit, appropriate nursing care and rehabilitation, including physiotherapy, occupational therapy and speech and swallowing therapy, are essential parts of recovery.

Preventing stroke: Small steps, major benefits

Prevention starts with identifying and controlling risk factors.

Control blood pressure. Hypertension is the leading modifiable risk factor for stroke. Have your blood pressure checked regularly and take prescribed medication consistently.

Manage diabetes and cholesterol. Maintain good glucose control and use statins or other lipid-lowering treatment when indicated by your cardiovascular risk.

Stop tobacco use. Smoking and smokeless tobacco increase vascular risk. Avoid both.

Move regularly. Aim for at least 150 minutes of moderate-intensity physical activity weekly, supplemented by strength training as appropriate. Walking counts.

Eat a heart-healthy diet. Emphasise vegetables, fruits, pulses, whole grains, nuts and other minimally processed foods. Reduce excess salt, processed foods and unhealthy fats.

Maintain a healthy weight and sleep well. Address obesity and seek assessment for possible sleep apnoea.

Check for atrial fibrillation. This irregular heart rhythm can cause clots that travel to the brain. People with atrial fibrillation may need anticoagulants, depending on their individual risk.

Avoid alcohol and harmful drug use. People who have already experienced a stroke or TIA need an individualised prevention plan, which may include antiplatelet medicines, anticoagulants, cholesterol-lowering therapy or treatment of carotid artery disease.

Stroke can strike at any age, including in people who appear healthy. Knowing the warning signs may save the life of someone you love.

Teach your family to recognise BE-FAST. Know the nearest stroke-capable hospital. Never ignore sudden neurological symptoms.

When stroke strikes, do not wait and do not watch. Act FAST. Every minute counts.

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.