Warning signs of a stroke as NHS warns not to delay calling 999

Hannah Millington
·Health & Wellness Reporter
Updated ·9-min read
Stressed senior mature man feeling pain having heart attack talking on phone hearing bad news, old middle aged male calling emergency touching chest suffer from heartache disease at home, infarction
People mistakenly believe they should have two or three stroke symptoms before calling 999 becomes necessary, according to NHS data. (Getty Images)

NHS England is urging people not to delay calling 999 if they experience the first sign of stroke, after new data analysis revealed the average time taken to do so was nearly an hour and a half.

A team at King's College London analysed more than 41,000 calls made in the last year by stroke patients who were taken by ambulance to hospital.

The health service also carried out a poll that found people mistakenly believe they should be experiencing two or three stroke symptoms before it became necessary to call 999.

Professor Sir Stephen Powis, medical director of NHS England, said: "These figures highlight very clearly that we must do more to support people to recognise the symptoms of stroke in themselves and others, and take action to call 999 at the earliest opportunity."

Stroke symptoms can be "less obvious or dramatic than you might expect", he said, adding that any sign of stroke is always an emergency.

As many as 100,000 people have strokes every year – equivalent to one every five minutes, according to the Stroke Association. While people who have them are often older, Beverly Hills 90210 star Luke Perry's tragic death from a stroke at just 52 is a reminder that younger people can have them too, and this also includes children.

Senior woman taking measures blood pressure at home to prevent stroke. (Getty Images)
Knowing how to respond if someone has a stroke is vital. (Getty Images)

While this may seem daunting, learning about strokes and how to respond can help minimise the impact.

"It is vital that stroke is reported on more because 90% of strokes are preventable due to lifestyle changes," says the Stroke Association.

"So [we need to be] informing the public that making small changes or checking your blood pressure could help save their life."

"It is also important that the true impact of stroke is highlighted," a spokesperson says and that "people know to call 999 and Act FAST as time is so important when having a stroke." With help from the charity, here's everything you need to know...

Brain stroke, haemorrhagic and ischaemic problem. Arteriosclerosis, infarct, ischemia, thrombosis disease. High ldl and hdl level. Cholesterol in human blood vessels. Medical poster vector illustration. (Getty Images)
Two types of stroke include haemorrhagic and ischaemic. (Getty Images)

A stroke is a brain attack that happens when the blood supply to part of the brain is cut off, which kills brain cells. The effect of a stroke depends on where it takes place in the brain, and how big the damaged area is.

There are three main types of a stroke. As mentioned, Ischaemic (a clot), the most common, is caused by a blockage cutting off the blood supply to the brain.

Haemorrhagic (a bleed) is caused by bleeding in or around the brain. About 85% of all strokes are ischaemic and 15% are haemorrhagic.

A transient ischaemic attack or 'TIA' is also known as a 'mini-stroke', because while it is the same as a stroke, the symptoms only last for a short amount of time as the blockage that stops the blood getting to your brain is temporary. Treating TIAs urgently reduces the risk of stroke by 80%.

Man struggling with vision. (Getty Images)
Recognising the signs of a stroke can help you to access care and treatment quickly for yourself or someone else. (Getty Images)

"It can happen to anyone, of any age, at any time," says Juliet Bouverie OBE, chief executive at the Stroke Association. "It is vital to know the signs and symptoms of a stroke: Face, Arms, Speech and Time (to call an ambulance)."

To help detect the medical emergency, follow the FAST test:

  • Facial weakness: Can the person smile? Has their mouth or eye dropped?

  • Arm weakness: Can the person raise both arms?

  • Speech problems: Can the person speak clearly and understand what you say?

  • Time to call 999: If you see any of these signs

This can help to spot the three most common symptoms of stroke, but there are other serious signs to have on your radar too:

  • Sudden weakness or numbness on one side of the body, including legs, hands or feet

  • Difficulty finding words or speaking in clear sentences

  • Sudden blurred vision or loss of sight in one or both eyes

  • Sudden memory loss or confusion, and dizziness or a sudden fall

  • A sudden, severe headache

Read more: Mum left disabled after doctors dismissed stroke as 'high blood sugar'

Man smoking a cigarette. (Getty Images)
Changing certain lifestyle factors can help prevent a stroke. (Getty Images)

As we get older, our arteries naturally become harder and narrower and are more likely to become blocked, but certain factors can speed up the process or increase the risk.

“Around 90% of strokes are linked to a treatable health condition such as high blood pressure or a ‘lifestyle’ factor such as smoking," says Bouverie. "Everyone has a different risk of having a stroke, which depends on their body and their lifestyle.”

Risk factors include:

  • Age

  • Health problems: High blood pressure, TIA, atrial fibrillation (irregular heartbeat), high cholesterol

  • Lifestyle choices: Smoking, diet, lack of exercise, not managing your weight, drinking alcohol

  • Family history: You are more likely to have one if someone in your family has had one

  • Ethnicity: Strokes occur more often in people from African or Caribbean families, and are also more common in people from South Asian countries such as India, Pakistan, Bangladesh

To reduce your risk of having a stroke, you can make lifestyle changes such as cutting down on alcohol, stopping smoking, staying a healthy weight, eating healthily and being as active as you can.

If you're over 40, regular check-ups with your GP will help pick up on any medical conditions that might put you at risk. If you're Black or from a South Asian family, you can have a diabetes check from the age of 25.

Health worker holding patient's hand. (Getty Images)
Getting treatment quickly is key to a better recovery. (Getty Images)

There are different types of treatments for strokes, dependent on what type the individual had and what course of action is right for them.

“Some people who have an ischaemic stroke are eligible for thrombolysis, a clot-busting drug which disperses the clot and returns the blood supply to your brain," explains Bouverie. After thrombolysis, 10% more patients survive and live independently.

"Thrombectomy is another treatment, this physically removes a clot from the brain," Bouverie adds. "Like thrombolysis, it has to be carried out within hours of a stroke starting which is why it is vital to act FAST. Only a small proportion of stroke cases are eligible for thrombectomy but it can have a big impact on those people by reducing disability.”

Stroke is a leading cause of adult disability. For every 1,000 patients thrombolysed within three hours, about 100 more were alive and living independently than for 1,000 patients who were not thrombolysed.

Woman after a stroke. (Getty Images)
After a stroke it is normal to be affected mentally as well as physically. (Getty Images)

Again, the effects of a stroke are different, but it can impact:

  • Movement and balance: Weakness down one side of the body, problems with balancing and walking, difficulty using legs, feet, arms or hands

  • Other physical problems: Swallowing problems, losing bowel and bladder control, fatigue, muscle and joint pain

  • Thinking and communicating: Problems with memory, concentration and problem-solving, problems with speaking, understanding, reading and writing, and spatial inattention

  • Sensory problems: Eyesight problems, being sensitive to light, and losing part of the visual field, numb skin, and pins and needles

Around one third of stroke survivors have aphasia, a difficulty with their language, which often comes from a stroke in the left side of the brain and can affect speaking, reading, writing and understanding speech.

Some people might also behave differently after a stroke, and become irritable, speak or do things without thinking, become very quiet and withdrawn, or lose interest in things they used to enjoy.

Another important thing to be aware of is that many are impacted emotionally after a stroke, and experience feelings of shock, anger, guilt and grief. It's common to have problems such as low mood, anxiety or depression.

People might also experience emotionalism, which means it can be hard to control your emotions. While it can be hard to talk about your feelings, it can help to talk to someone you trust or a professional.

Comforting woman in hospital after a stroke. (Getty Images)
Recovery from a stroke looks different for different people. (Getty Images)

There are 1.3 million stroke survivors in the UK. "Depending on how serious the stroke is, the stroke survivor may stay in hospital for anything from a few days to a few months," explains a spokesperson from the Stroke Association.

"They might move to a rehabilitation ward and will work with a team of health professionals specialising in stroke to help rebuild their life.

"After having a stroke, the body will need time to heal and recover," the charity adds. "Rehabilitation helps people to make the best recovery possible so they can relearn skills for everyday life.

"Because every stroke is different, there is no set pattern for recovering from one. The quickest recovery takes place in the days and weeks after a stroke. But recovery can continue for months and years after a stroke.

"Stroke survivors tell us that it can take a lot of effort and determination to keep going with rehabilitation. It can be very hard work, physically and mentally, but many people find it helps them make vital progress with speaking, walking and other key skills."

"Stroke changes lives in an instant, but the brain can adapt. If you think you or someone you know is having a stroke Act FAST and call 999 as a stroke is a medical emergency," says the Association.

If you have been affected by a stroke, including as family, friends and carers, you can call the Stroke Association's helpline on 0303 3033 100 or email helpline@stroke.org.uk.

Its online tool My Stroke Guide also gives you free access to trusted advice, information and support 24/7, connecting stroke survivors to its online community to find out how others manage their recovery.

Additional reporting PA.

Watch: Emmerdale's Mark Charnock flags up stroke symptoms

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