Signs & Symptoms: Understanding the warning signs of a stroke

A stroke requires immediate hospital care, but most Americans don’t recognize the symptoms of this potentially deadly “brain attack.” This widespread lack of awareness often results in preventable long-term disabilities.

A survey by the Centers for Disease Control and Prevention in 13 states and the District of Columbia revealed most people can’t identify the five most common symptoms of stroke: sudden confusion or trouble speaking, numbness, weakness or paralysis of the face or appendages, especially on one side; sudden vision impairment; dizziness and loss of balance; and severe headache.

The 2008 survey found less than 44 percent of survey respondents correctly identified all symptoms. These findings are concerning because prompt treatment is necessary to save brain tissue after a stroke occurs. With each passing minute, 2 million brain cells die, increasing the risk of permanent brain damage, disability, and death.

When the cells die, abilities controlled by that area of the brain, such as speech, movement or memory, are impaired or lost. In the U.S., stroke is the leading cause of adult disability and the third leading cause of death, killing 160,000 people each year, according to the National Stroke Association, Centennial, Co.

“Every minute counts. Saving neurons through early intervention is critical. The goal is to treat a patient with stroke symptoms as early as possible: before 3 hours of symptom onset,” says Dr. Herminio Cuervo, a Lakeland neurologist and Polk County Medical Association member.

The symptoms are more significant when they occur in combinations. “For example, difficulty speaking with right facial numbness and right arm weakness is much more life threatening than facial tingling alone,” Dr. Cuervo points out.

“Strokes are caused by a disruption of blood flow in an artery inside the brain or in one of the major arteries in the neck, which feed the brain (carotid or vertebral arteries),” Dr. Cuervo explains. Some are caused by blood clots, others by plaque that block blood flow within the arterial wall, and others by arteries that break or hemorrhage during a hypertensive crisis.

Other conditions can mimic a stroke including intoxication, the effects of medication, illnesses that interfere with neurological function, and changes in blood sugar levels, Dr. Cuervo observes.

“An easy tool to remember is the FAST test: Face, Arm, Speech and Time (call 911 immediately),” he adds.

For the best possible outcome following a stroke, a clot-dissolving medication called tissue plasminogen activator, or tPA, must be administered within three hours of the onset of symptoms.

Beyond that three-hour window, only hospitals with comprehensive stroke centers can provide advanced interventional procedures, such as mechanically removing the clot causing the stroke, to stall or reverse damage to the brain. (Visit to locate your nearest stroke center.)


MEET THE DOCTOR: Herminio Cuervo, MD

Born in Havana, Cuba, Dr. Herminio Cuervo comes from family line of doctors: His father was an orthopedic surgeon and his great-grandfather was a Spanish Army surgeon who settled in Cuba after the Spanish-American War. His mother was a teacher/school principal.

He relocated to the United States in 1961, later studied medicine at the University of Salamanca, Spain, and completed his training as a neurologist at Harvard University.

Dr. Cuervo worked with the U.S. Air Force in Spain, Morocco, Greece, Italy, Turkey, Germany, Qatar and Honduras before separating from the service after Desert Storm. He relocated to Lakeland in 1993.

“The most important thing a person can do about strokes is to prevent them,” says Dr. Cuervo, who offers neurological services for adults and children. “Maintain proper weight for height, exercise regularly to control calories and blood pressure. Avoid tobacco and limit alcohol intake.”



story by Dawn Klingensmith


Accessibility Toolbar