Every year, 1.8 million Indians suffer a stroke. Stroke is now the second leading cause of death and the leading cause of adult disability worldwide. What makes this tragedy even more devastating is that most strokes are treatable if you act fast enough. The difference between full recovery and permanent disability is often a matter of minutes.
What Happens During a Stroke
A stroke occurs when blood supply to part of the brain is suddenly cut off. Without oxygen, brain cells begin to die within minutes. Approximately 1.9 million neurons are lost every minute an ischaemic stroke goes untreated which is why neurologists use the phrase "time is brain".
There are two main types: Ischaemic stroke (87% of cases) occurs when a clot blocks a brain artery. Haemorrhagic stroke occurs when a blood vessel in the brain bursts. Both are emergencies requiring immediate hospital treatment, but the management is different which is why getting a brain scan quickly matters so much.
The FAST Signs
Face Drooping
Ask the person to smile. Does one side of their face droop or appear uneven? Facial weakness particularly one-sided is one of the most reliable early signs of a stroke. It may be subtle: a slightly crooked smile, difficulty closing one eye, or numbness on one side of the face.
Arm Weakness
Ask the person to raise both arms. Does one drift downward? One-sided arm weakness or numbness is a classic sign of stroke. It may present as difficulty gripping, dropping objects, or an arm that simply feels "not right". Some patients describe their arm as feeling heavy or foreign.
Speech Difficulty
Ask the person to repeat a simple sentence: "The sky is blue." Is their speech slurred, strange, or impossible to understand? Are they struggling to find words? Speech problems in a stroke can range from mild slurring to complete inability to speak or understand language (aphasia).
Time to Call Emergency Services Immediately
If you observe any of these signs even one, even if you're not sure call emergency services immediately. Note the exact time symptoms started. This information is critical: clot-busting treatment (thrombolysis) is most effective within 4.5 hours of symptom onset, and mechanical clot removal (thrombectomy) within 24 hours for selected patients.
Other Warning Signs Not in FAST
The FAST acronym covers the most common signs but not all of them. Other stroke symptoms include sudden severe headache described as "the worst headache of my life" (often a haemorrhagic stroke), sudden loss of vision in one or both eyes, sudden dizziness, loss of balance, or difficulty walking. A transient ischaemic attack (TIA) sometimes called a mini-stroke produces identical symptoms that resolve within minutes to hours. Do not ignore a TIA: it is a medical emergency and a warning that a major stroke may follow within days.
Never "Wait and See"
Even if symptoms resolve, a TIA requires emergency hospital assessment within 24 hours. The risk of a full stroke in the days following a TIA is highest in the first 48 hours. Do not drive to hospital call for emergency transport.
At MNR Hospital's Stroke Unit
MNR Hospital's dedicated stroke unit provides 24/7 acute stroke management including emergency brain imaging (CT scan within 30 minutes of arrival for eligible patients), intravenous thrombolysis, and a telemedicine network with tertiary centres for thrombectomy referral. Early stroke rehabilitation physiotherapy, speech therapy, occupational therapy begins within 24 hours of stabilisation, which significantly improves long-term functional outcomes.
Knowing the FAST signs and acting on them could mean the difference between a full recovery and a lifetime of disability for someone you love.
Dr. Deepak Shenoy
Dr. Deepak Shenoy is a Senior Neurologist and Stroke Specialist at MNR Hospital with 20 years of clinical experience. Trained at NIMHANS Bengaluru, he leads the hospital's dedicated stroke unit and has established primary thrombolysis services for acute stroke management in Coastal Karnataka.
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