Neurology

Stroke — Symptoms, Emergency Response, and Treatment Time Windows

How to recognise stroke symptoms, what to do immediately, and how modern stroke treatments work — including today's timing windows.

Updated: 5 min read

Stroke: Act Fast — Treatment Has Improved, But Time Still Matters

A stroke is a medical emergency caused by interrupted blood flow to the brain. Without oxygen, brain cells begin to die within minutes.

Fast recognition and emergency response can save a life — and reduce disability.

The good news: modern stroke systems can treat more people than ever before, including some who arrive later than the old “cut-offs.”
The rule that never changes: if you suspect a stroke, call emergency services immediately.

The FAST Test

Remember FAST:

  • F — Face: drooping or numbness on one side
  • A — Arms: weakness or inability to raise both arms evenly
  • S — Speech: slurred, confused, or strange speech
  • T — Time: call emergency services immediately

Do not wait to see if symptoms improve.

Other Stroke Symptoms You Should Never Ignore

Call emergency services if you notice:

  • Sudden vision changes (blurred, double, or loss of sight)
  • Sudden confusion or trouble understanding speech
  • Sudden numbness or weakness in face/arm/leg (especially on one side)
  • Sudden loss of balance, severe dizziness, or coordination problems
  • Sudden, severe headache with no known cause

If Symptoms Go Away, It’s STILL an Emergency (TIA / “Mini-Stroke”)

A Transient Ischemic Attack (TIA) causes stroke-like symptoms that resolve within minutes to hours.

Important:

  • A TIA is not harmless
  • It is a strong warning sign of a future stroke
  • Many major strokes occur within days of a TIA

Even if symptoms disappear, urgent medical assessment can prevent a larger stroke.

Stroke Treatment Timing: What Patients Should Know

Doctors use the time the person was last known well (the last moment they were definitely normal) plus brain imaging to choose treatments.

1) Clot-busting medication (thrombolysis)

  • Works best when given as soon as possible
  • Commonly used within 4.5 hours of last known well
  • In selected cases, advanced imaging may support treatment beyond 4.5 hours (for example, some “wake-up” strokes or late presenters)

2) Clot removal (thrombectomy)

  • Used for some strokes caused by a large vessel blockage
  • Can be effective in the early hours
  • In selected patients, may be considered up to 24 hours from last known well, based on imaging and clinical factors

Key takeaway: Don’t self-triage based on the clock. Call immediately. Let stroke specialists decide what’s possible.

Why Doctors Ask “When Did This Start?”

Because treatments depend on:

  • when symptoms began (or last known well)
  • what brain imaging shows
  • overall safety and benefit

If you’re with someone having a stroke:

  • note the exact time symptoms started (or when they were last seen normal)
  • tell emergency staff immediately

Stroke Can Happen at Any Age (Including Children)

Stroke can occur in:

  • older adults
  • young adults
  • children (rare, but real)

If a child has sudden weakness, speech trouble, severe confusion, or collapse, treat it as an emergency.

What To Do While Waiting for Help

  • Stay with the person and keep them calm
  • Keep them safe (sitting or lying down)
  • Do not give food, drink, or medication
  • Note the time symptoms began / last known well

Prevention: Reduce Your Stroke Risk

  • Control blood pressure
  • Manage cholesterol and diabetes
  • Don’t smoke
  • Exercise regularly
  • Take prescribed medications exactly as directed (especially blood pressure meds and blood thinners if indicated)

Myth vs Fact

Myth: Stroke only happens to the elderly.
Fact: Stroke can occur at any age, including children.

Myth: If symptoms disappear, it’s nothing serious.
Fact: A TIA is a medical emergency and warning sign.

Myth: It’s too late if you didn’t get help immediately.
Fact: Some people can still be treated later depending on imaging — but earlier is always better.

FAQ

Q: What should I do if I’m not sure it’s a stroke?
A: Treat it as a stroke anyway. Call emergency services immediately.

Q: Is a “mini-stroke” really urgent if it went away?
A: Yes. A TIA can be a warning sign of a major stroke in the next hours or days.

Q: What is “last known well”?
A: The last time the person was definitely at their normal baseline. This is often more important than when symptoms were first noticed.

Q: Can children have strokes?
A: Yes. It’s rare, but it happens, and it’s an emergency.

Educational only; not a substitute for professional medical advice.