Want to Save Some Lives? Here is a Simple Formula for Identifying Strokes

By Don Hazen, AlterNet. Posted December 22, 2008.

If the study's findings hold up, it would mean that recognizing a stroke has taken place would be something just about anyone could do and would be a skill worth mastering in light of the importance of getting medical attention for stroke victims at the earliest possible moment.

Focal neurological signs such as slurred speech, unilateral facial droop, blurred vision, discoordination and partial or total paralysis are often indicative of some sort of brain dysfunction and would be recognized as important markers by those in the medical profession. However, expecting lay people to diagnose that something has gone terribly wrong in a loved one on the basis of that checklist would be reaching for too much; in that key moment, few would be likely to remember what they were supposed to be looking for.

The e-mailed advice, as circulated in 2006, contains this additional suggestion: "NOTE: Another 'sign' of a stroke is this: Ask the person to 'stick' out their tongue. If the tongue is 'crooked', if it goes to one side or the other, that is also an indication of a stroke." While that is also likely true, as a test it is far less valuable than the original three because there is room for interpretation of the results. How crooked is crooked, after all? How far to one side does the tongue have to go before its having done so can be regarded as a clear sign of a stroke having occurred? Better to discard this fourth suggested test in favor of remembering the first three.

By distilling the assessment process down to three simple tests (smile, raise both arms, speak a simple sentence), anyone is likely to remember what to ask of someone they suspect has just undergone a stroke and to correctly interpret the information so gleaned. (The tests are pass/fail, after all, so if the person they were administered to couldn't smile, couldn't raise her arms and was incoherent, the party observing all this wouldn't be at a loss for what to make of the results -- she'd conclude her friend had suffered a stroke.)

And it is important laypeople learn to recognize such events, because a new drug has been shown to limit disability from strokes caused by clots (ischemic), provided victims receive it within three hours of the onset of stroke symptoms. Tissue plasminogen activator (tPA) is a clot-busting drug administered intravenously in cases of ischemic stroke; however, only 1 in 50 stroke patients has a chance of this drug helping them because currently only 2 percent of them reach an emergency room in time for tPA to be given.

(It's possible tPA's effectiveness can be boosted by simultaneous massaging of the clot with ultrasound. Early results from a 2004 study performed in Houston on coupling this drug with such treatment are most encouraging.)

A 2005 updating of the e-mail included this statement: "A neurologist says that if he can get to a stroke victim within three hours he can totally reverse the effects of a stroke ... totally. He said the trick was getting a stroke recognized, diagnosed and then getting the patient medically cared for within three hours, which is tough. While getting appropriate medical care for a stroke victim as soon as possible is extremely important, doing so does not come with a 100 percent guarantee that a stroke identified and treated within a three-hour time frame will not cause permanent damage."

See more stories tagged with: health, strokes, stroke identification, stroke symptoms, tpa, tissue plasminogen activa

Don Hazen is the executive editor of AlterNet.

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