Warning over life-threatening signs of stroke that are easily missed

Stroke patients are dying or suffering life-long disabilities because people typically wait an hour and a half before dialling 999, the NHS has warned.

Health bosses say tens of thousands more victims could be saved or make a fuller recovery if the public called for an ambulance at the first sign of symptoms.

NHS England is today launching the first major update to its 'Act FAST' stroke awareness campaign since 2009.

It encourages people to act immediately if anyone experiences one of the three common symptoms, including struggling to smile, struggling to raise an arm or slurring their words.

Professor Sir Stephen Powis, national medical director at NHS England, said taking quick action could 'help save and protect many more lives'.

But the plea comes against a backdrop of slow ambulance response times, with crews routinely failing to arrive within the 18 minute target.

The latest NHS figures show the average response time for ambulances dealing with emergency calls, such as heart attacks and strokes, was 36 minutes and 2 seconds in September.

Around 100,000 people have a stroke each year in the UK, which occurs when the blood supply to part of the brain is cut off.

Without prompt treatment a stroke can result in death or long-term disabilities such as paralysis, memory loss and communication problems.

The NHS says rapid diagnosis and treatment is 'critical' as stoke victims may lose around 2million brain cells a minute, with delays contributing to greater harm and hampering recovery.

The average time between first stroke symptom and a 999 call being made was 88 minutes in 2023/24, according to new analysis of NHS data by the Sentinel Stroke National Audit Programme.

Its researchers, based at King's College London, examined the medical notes of 41,327 stroke patients where such figures were recorded.

Meanwhile, new NHS polling found 57 per cent of adults in England believe you should have two or three symptoms of a stroke before calling 999, despite just one being a sign of a medical emergency.

Nearly two thirds (64 per cent) of the 2,001 people questioned said they would not call 999 as their first course of action if they noticed someone was suddenly struggling to smile.

Sir Stephen 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, but even if it doesn't seem like it, any sign of stroke is always an emergency and it's vital you call 999 immediately.

'This campaign is so important. Greater awareness of the need to act fast and dial 999 could help save and protect many more lives, as we know that earlier recognition of symptoms and immediate action to call 999 can enable faster access to specialist treatment and the best chance of reducing long-term effects of a stroke.'

NHS England said more people are now surviving a stroke than ever before thanks to advances in care but strokes remain the fourth single leading cause of death in the UK, with 38,000 fatalities each year.

Juliet Bouverie, chief executive of the Stroke Association, said: 'Over 88,000 people survive a stroke every year in the UK, but surviving a stroke is just the start of a long and traumatic battle to finding their way back to life.

'Mums, dads, grandparents, young people, even children can be stroke survivors, and the impact of stroke on them and their loved ones can be catastrophic.

'This new NHS campaign is so important to help raise awareness that stroke is always a medical emergency.

'If you spot any of the three common signs of a stroke in someone, the first thing you should do is call 999. The quicker many stroke treatments are given, the better.

'As we say, "time is brain", so it's important to recognise any of the signs of a stroke and act immediately.

'Acting FAST is vital for stroke survival and to help improve the journey to recovery.'

THE CAUSES OF STROKE

There are two major kinds of stroke: 

1. ISCHEMIC STROKE

An ischemic stroke - which accounts for 80 per cent of strokes - occurs when there is a blockage in a blood vessel that prevents blood from reaching part of the brain.

2. HEMORRHAGIC STROKE

The more rare, a hemorrhagic stroke, occurs when a blood vessel bursts, flooding part of the brain with too much blood while depriving other areas of adequate blood supply.

It can be the result of an AVM, or arteriovenous malformation (an abnormal cluster of blood vessels), in the brain.

Thirty percent of subarachnoid hemorrhage sufferers die before reaching the hospital. A further 25 per cent die within 24 hours. And 40 per cent of survivors die within a week.

RISK FACTORS

Age, high blood pressure, smoking, obesity, sedentary lifestyle, diabetes, atrial fibrillation, family history, and history of a previous stroke or TIA (a mini stroke) are all risk factors for having a stroke.

SYMPTOMS OF A STROKE

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing or blurred vision in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

OUTCOMES

Of the roughly three out of four people who survive a stroke, many will have life-long disabilities.

This includes difficulty walking, communicating, eating, and completing everyday tasks or chores. 

TREATMENT

Both are potentially fatal, and patients require surgery or a drug called tPA (tissue plasminogen activator) within three hours to save them.