What Does a Stroke Feel Like?

Every second counts when someone is having a stroke. During a stroke, the blood flow to the brain gets disrupted by a blood clot or a brain bleed, damaging brain tissue. The more time passes before treatment for a stroke, the more likely that person will experience serious disability, paralysis, or even death.

One treatment, called TPA or tissue plasminogen activator, can dissolve the blood clot causing a stroke and restore blood flow—but only if given quickly enough. “It has to be delivered within a very narrow time window, 4.5 hours from stroke symptom onset,” explains Natalia S. Rost, MD, MPH, FAAN, FAHA. Dr. Rost is a Mass General Brigham neurologist and chief of the Stroke Division at Massachusetts General Hospital.

But what does a stroke actually feel like? While each person’s experience may vary, there are some common warning signs to look out for. Dr. Rost shares how to recognize the signs and symptoms you may be having a stroke and the importance of getting prompt treatment.

Physical signs and symptoms of a stroke

When it comes to stroke, think F.A.S.T. The American Stroke Association (ASA) shares the following warning signs: 

• F for face drooping: Does one side of the face feel numb or sagging? Is the person’s smile lopsided?
• A for arm weakness: Does one arm feel weak or numb? Can they raise each arm the same amount, or is one drifting downward?
• S for speech difficulty: Is the person slurring their words or struggling to talk?
• T for time to call 9-1-1: Call for emergency help as soon as you notice any symptoms and note when they appeared.

More recently, the FAST acronym has been adjusted to “BE FAST,” in order to add two other common stroke symptoms:

• B for loss of balance
• E for eye trouble (sudden vision loss or double vision)

“Having these acronyms help patients and their family, friends, or even bystanders identify symptoms of stroke. It also helps paramedics to be hypervigilant when they are called to evaluate sudden symptom onset–and to have a high index of suspicion. Because in stroke, better be safe than sorry.” says Dr. Rost.

Other physical signs and symptoms of a stroke can include:

• Numbness
• A sudden severe headache, often called a “thunderclap” headache
• Abnormal body part movements which patient can’t control

Cognitive signs and symptoms of a stroke

Because strokes take place in the brain, in addition to causing physical sensations and pain, they can also affect how people process the event as it’s happening. Cognitive signs and symptoms of a stroke can include:

• Confusion
• Difficulty understanding or remembering

What does a mini stroke feel like?

“A mini-stroke refers to a transient ischemic attack (TIA) and it’s often a misnomer,” says Dr. Rost.

In a TIA, the disruption of blood flow to the brain is only temporary. This can be due to a blood clot that gets dislodged or a small bleed called a microhemorrhage.

The signs and symptoms of a TIA are similar to a regular stroke but aren’t permanent and usually last for 5 minutes or less.

“Sometimes this temporary loss of brain function is not minor at all – a person can get paralyzed or lose their speech, or vision. In TIA, those always come back. But even if the function returns quickly, some brain damage could have already occurred. That’s why seeing a specialist as soon as possible to determine if damage has occurred is the only way to proceed after a TIA,” says Dr. Rost.

TIA strokes can be a warning sign that a full stroke will happen soon—according to the Centers for Disease Control and Prevention (CDC), 1 in 3 people who has a TIA will have a major stroke within a year without proper treatment.

“TIA symptoms need to be treated with the same urgency as a regular stroke. Do not hesitate, call 911!” Dr. Rost emphasizes.

Stroke recovery

Depending on how severe the stroke was, and where it occurred in the brain, people can experience the following effects of a stroke:

• Paralysis or weakness on both or one side of the body
• Trouble with language, understanding, memory, attention, and regulating emotions
• Trouble with speaking, chewing, and swallowing
• Difficulty with bodily functions like bowel and bladder control
• Mental health issues like depression or anxiety

Each person’s recovery from a stroke is unique. Once your condition has stabilized, your health care team, led by a neurology specialist and including your primary care provider (PCP), develops a treatment plan according to your individual needs.

“This treatment plan will include both rehabilitation services (like physical, occupational or speech therapy), as well as a plan for prevention of future strokes,” says Dr. Rost.

Some people require intensive rehabilitation services, but many can regain function over time. Ultimately, recovery is possible.

“The most important rule of stroke recovery is to never give up. Everyone’s journey might be personal, but with support, care, and daily effort, progress is inevitable. Stroke is preventable. Treatable. Beatable. Work closely with your neurologist and primary care doctor to help you achieve your goals,” Dr. Rost says.