Stroke warning signs: Doctors explain why every minute matters in treatment

When it comes to a stroke, every minute can make a difference between recovery and lasting disability. As doctors marked World Stroke Day on October 29, they reiterated the importance of recognising symptoms early and rushing patients to a hospital equipped to provide specialised stroke care. Survivors and their families, meanwhile, recounted how quick action helped them navigate a medical emergency that can strike without warning.

At a press conference organised at Gleneagles Hospital in Parel, Mumbai, neurologists stressed that stroke is a medical emergency that requires immediate attention. Timely treatment, particularly when initiated within the first 4.5 hours in eligible patients with an ischaemic stroke, can significantly improve outcomes. Delays can result in irreversible brain damage and long-term disability.

“Stroke is a medical emergency in which every minute matters. We do see strokes in younger persons and even, at times, babies. It is from womb to tomb,” said Dr Nitin Dange, an interventional neurologist and neurosurgeon.

He cautioned people against attempting home remedies or waiting for symptoms to subside. “Stroke treatment is my passion. Awareness is all. If you even suspect something is wrong, rush to a hospital. Do not try all kinds of home treatment,” he said.

Dr Pankaj Agarwal, director of Neurology, Stroke and Neurocritical Care at the hospital, underscored the urgency of treatment, describing the condition in stark terms.

“Stroke is a devil with many faces,” he said, highlighting the need to recognise the varied ways in which a stroke can present.

A stroke occurs when blood supply to a part of the brain is interrupted or when a blood vessel in the brain ruptures. The resulting damage can affect movement, speech, vision and other vital functions. While age and underlying health conditions can influence risk, stroke is not restricted to older people.

Dr Agarwal pointed out that sudden visual disturbances, seizures and problems with balance can also be warning signs, even in the absence of the typical weakness on one side of the body. He cited the case of Praveen Khatu, a stroke survivor who experienced a seizure and saw coloured spots. Since Khatu reached the hospital within the critical treatment window, doctors were able to administer clot-busting medication. He has since recovered well and is back to leading a healthy life. Agarwal said Khatu had also been diligent about taking his medication and managing his health after the stroke. The case, he said, underlines why people must not overlook unusual symptoms and should seek medical attention immediately.

For Praveen Khatu, the warning signs were unusual and difficult to ignore. His right arm began pulling and moving involuntarily, while his vision changed and he started seeing different colours. Recognising that something was wrong, he sought medical attention.

Satish Nikam, another survivor who shared his experience at the event, recalled feeling slightly dizzy. His wife recognised that he needed medical help and rushed him to the hospital.

Their experiences underline why people should not dismiss sudden neurological symptoms as fatigue, dizziness or a temporary problem. Even symptoms that appear to improve can indicate a transient ischaemic attack, sometimes called a mini-stroke, which requires urgent medical evaluation.

For Adit Bhatt, the emergency unfolded when his wife, Tejal Bhatt, 47, developed weakness and loss of sensation in her left arm and began feeling unwell. It began around 4.35 pm when she told her husband, Adit, that she felt uneasy and could not stand properly. When he checked her left hand, he realised she could not feel it or lift it; when he raised it, it fell back down. Recognising that something was seriously wrong, he contacted their family doctor and then Dr Pankaj Agarwal, who urged him to bring her to the hospital immediately. The couple travelled from Ghatkopar to Gleneagles Hospital in Parel, reaching the emergency department in about 30 minutes. Doctors promptly assessed her and arranged an MRI before proceeding with treatment. Recalling the urgency of those moments, Adit said Agarwal had told him over the phone that he had only 10 minutes and instructed the team not to waste time. 

"Doctors asked for the exact time her symptoms had begun, highlighting how crucial this information is when determining eligibility for time-sensitive stroke treatments," says Adit.

Tejal recovered from the stroke, although she remains wheelchair-bound while recovering from Guillain-Barré syndrome (GBS), a separate neurological condition for which she is receiving treatment.

Adit said the experience had reinforced one message for the family: “Do not lose a single second. Time is very critical. Talk to your doctor immediately. Go to the nearest hospital and get yourself treated. You can save the organ. You can save precious life.”

The warning signs

Doctors advised people to remember the BE FAST acronym to identify possible stroke symptoms:

• B — Balance: Sudden loss of balance or coordination.
• E — Eyes: Sudden loss or blurring of vision in one or both eyes.
• F — Face: Drooping or asymmetry on one side of the face.
• A — Arms: Sudden weakness or numbness in an arm, particularly on one side.
• S — Speech: Difficulty speaking, slurred speech or trouble finding words.
• T — Time: Call an ambulance immediately and get the person to a stroke-ready hospital.

Preventive measures remain equally important. Dr Sangeeta Rawat, a consulting neurologist, stressed the role of a balanced diet, exercise, quality sleep and monitoring blood pressure, blood sugar and cholesterol. Avoiding tobacco and smoking is also crucial in reducing stroke risk.