Signs of a Stroke

(Originally posted on bcotoronto.com on April 18th, 2013)

Stroke is an extremely important topic in chiropractic and so it is incredibly important that chiropractors know how to identify a stroke when it is in progress. It is also important for you as the general public to be able to identify a potential stroke because the sooner someone suffering from a stroke is taken to a hospital, the better their prognosis will be.

There are some commonly known tools for identifying strokes out there but I would like to repeat them here because everyone should know them. They are easy to remember because they start with the same three letters as Stroke. STR.

S stands for Smile. A stroke almost always affects one side of the brain and so on side of the face will experience weakness in the muscles that allow us to for expressions. A person suffering from a stroke will have a lop-sided smile or even a smile on one side and a drooped, limp lower lip on the other.

T stands for Talk. As the person you suspect of having a stroke to speak to you. It doesn’t matter what they say just that they are trying to form words. The muscles of the tongue are mirrored down the middle and like the muscles of the face one side gets its nerve supply from one side of the brain and the other side gets it from the other. Add this on to the already weak lips and you can’t form words properly. It will sound as if the person is slurring their sentences.

R is for Raising Your Arms. Like the muscles of the face and the tongue, the muscles of the body are mirrored down the middle and each side gets their nerves from one half of the brain. So shrugging their shoulders or raising their arms above their head would be difficult on one side for someone having a stroke. This is, of course, assuming that they could perform this task previously.

So those are the three common “Public Education” signs of stroke that people usually know because they are posted in your office first aid room or all over the internet in chain e-mails. The one other symptom that people generally know about is numbness along one side of the body but this can’t really be tested in an observable way.

There is a lot more to a stroke than just these signs and symptoms. I would like to walk you through a little bit so that you will be able to identify more of these signs and help people get to the proper care they need.

The brain is very organized and so different functions are located in different, distinct areas. So when a stroke happens, only the areas that immediately surround the bleeding artery or vein will be affected. While muscle control is the most common area to be effected it is by far not the only one. In some cases people are still able to speak clearly and move without difficulty.

In general, one of the signs that doctors look for in identifying a possible stroke is patients complaining of the “Worst Headache of their Life”. Of course, this statement is prone to exaggeration so you need to be careful not to jump to conclusions on this one. If you are concerned, ask them to clarify.

During a stroke essential senses can be compromised like balance, vision, smell, or hearing. Generally this means an increase signal from these senses rather than a loss of sense such as blurred vision or seeing auras, smelling a scent that is not there, or a ringing in the ears. Any one of these alone could be a number of different things but probably not a stroke, although they should still be evaluated by a doctor. When in combination they become truly concerning.

Nausea & vomiting are also commonly associated with conditions influencing the brain. When these symptoms occur without provocation always take that person to the emergency room.

So if you think that someone near you or even yourself is experiencing a stroke, start with the STR questions and then add to them with what you have learned here today.

Thanks for reading,
Dr. Ben

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