F.A.S.T. Action During a Stroke Can Save Lives

A critical reminder on this Stroke Awareness Month — the first moments of a stroke can make the difference between recovery, lifelong disability, or death. As harsh as that may sound, as a neurologist, it’s one of the most important messages I share with my patients.

Why time is critical

A stroke occurs when the blood flow to part of the brain is interrupted — either by a blockage (ischemic stroke) or bleeding (hemorrhagic stroke). Without oxygen-rich blood, brain cells begin to die within minutes. That’s why we say ‘time is brain.’ Every minute a stroke goes untreated can result in irreversible damage. Fast medical care can significantly reduce the severity of disability and improve survival.

Many of the most effective treatments are only available within a narrow window:

• Clot-busting medications (tPA) must often be given within 3 to 4.5 hours of symptom onset.
• Some advanced procedures, such as mechanical clot removal, may be available up to 24 hours in select cases, but earlier is always better.

The sooner treatment begins, the better the outcome.

Why it’s important to act F.A.S.T.

Stroke symptoms typically appear suddenly and without warning. Recognizing them quickly can save a life. Use the F.A.S.T. acronym:

• F – Face drooping: One side of the face may droop or feel numb
• A – Arm weakness: One arm may feel weak or drift downward
• S – Speech difficulty: Slurred or difficult speech
• T – Time to call 911: Don’t wait, call immediately

Additional warning signs include:

• Sudden confusion or trouble understanding speech
• Sudden vision problems
• Sudden dizziness, loss of balance, or coordination
• Severe headache with no known cause

Even if symptoms disappear quickly (a “mini-stroke” or TIA), it’s still a medical emergency and a warning sign of a future stroke.

What to do if you suspect a stroke

If you experience stroke symptoms:

1. Call 911 immediately — do not drive yourself
2. Note the time symptoms started — this helps guide treatment decisions
3. Stay with the person and keep them safe until help arrives

Emergency medical teams can begin lifesaving care before reaching the hospital, which helps improve outcomes.

Common stroke myths and the truth

• Myth 1: Stroke only happens to older adults
  Truth: Stroke risk increases with age, but it can occur at any age, even in young adults.
• Myth 2: Symptoms have to be severe to be a stroke
  Truth: Even mild or temporary symptoms require immediate attention.
• Myth 3: You can ‘wait it out’ to see if symptoms improve
  Truth: Delaying care can cost critical treatment time and lead to permanent damage.
• Myth 4: There’s nothing you can do to prevent a stroke
  Truth: Many strokes are preventable by managing risk factors like high blood pressure, diabetes, smoking, and high cholesterol.

Treatment Options

Treatment depends on the type of stroke:

• Ischemic Stroke (most common):
  • tPA (clot-busting medication): Dissolves clots and restores blood flow
  • Mechanical thrombectomy: A minimally invasive procedure to remove large clots
• Hemorrhagic Stroke:
  • Medications to control bleeding and pressure
  • Surgical interventions in some cases

What you can do to prevent a stroke

While not all strokes are preventable, you can significantly lower your risk by:

• Controlling blood pressure
• Managing diabetes and cholesterol
• Avoiding tobacco use
• Eating a healthy diet and staying active
• Keeping regular medical appointments

Stroke is a medical emergency. Knowing the signs, acting quickly, and seeking immediate care can save brain function, independence, and lives.

Remember: Don’t wait. Don’t hesitate. Act F.A.S.T.

By Venkata Siva Ramakrishna Dandamudi, MD, Neurology