Stroke Symptoms: Think You Know Them All?

Thanks to effective public awareness campaigns, many of us are familiar with the common signs of stroke. Think of the television ads that show us what to look for if we think someone is having a stroke.  The mnemonic “F-A-S-T” reminds us to look at the Face (is it drooping?), Arms (can you raise both?), and Speech (is it slurred?), and to waste no Time in getting help.

This checklist is a potential lifesaver because when it comes to strokes time is of the essence. But there’s more to the story. That’s because there’s more to the anatomy of our brains than what can be incorporated into a simple memory jogger of stroke symptoms. I learned this the hard way.

I’ve written elsewhere about the fascinating system that feeds blood into the human brain. More on that very soon. (By the way, everything I write on medical matters is in layman’s terms.) In brief, there are two main sets of arteries, the carotids and the vertebrals. These arteries are found in the front and back of the neck, respectively.

The carotids are the workhorses, accounting for about 80 percent of the total blood flow to the brain. And these are the arteries that, if they get blocked or damaged, can result in the symptoms noted above.

In 2017, I began to experience symptoms that didn’t fall into the handy, F-A-S-T category. Over a period of two months, I had several episodes of vertigo. I saw strange artifacts in my field of vision. I had a sensation that my body had become disconnected from my brain.

Then, one morning in July 2017, I woke up feeling odd. The first things I did were look in the mirror (to see if my Face was drooping) and talk (to see if my Speech was slurred). They weren’t. I could move my arms and legs, although they felt strangely heavy and lethargic. Naturally, I concluded I wasn’t having a stroke.

The scans done later that day in the ER said otherwise.

It turns out I had developed a blockage in my left vertebral artery. These arteries, left and right, run from a point about the level of your collarbones at the back of the neck. They join up to form the basilar artery, which feeds blood to the back of the brain. The vertebrals account for about 20 percent of the blood flow to the brain, and when they are blocked, functions like balance and coordination, including visual and hearing coordination, are affected.

The blockage in my vertebral artery had probably been there for some time before it started to cause symptoms. Until my situation was eventually brought under control, after a lengthy stay in the Foothills Medical Centre stroke ward, I experienced a wide range of symptoms. I had my eyes and ears go out of sync, as if someone had gotten hold of the control knobs in my brain and started twisting them randomly. My tongue turned into a frozen lump. My arms went into jerky spasms. It was not pleasant.

The reason I’m explaining all this is to share what I’ve learned. While catchwords are helpful, they don’t tell the whole story. If you, or someone you care about, is having any of the above symptoms or a long list of others[1], get it checked out immediately. Symptoms that are caused by a blockage in the vertebral arteries can be deadly serious, just like those in the carotid arteries.

By the way, when I did some research into the F-A-S-T mnemonic, I found some recommendations that it be modified to BE FAST. Why? The B and E would include Balance and Eye trouble in the checklist of stroke symptoms. This version of the mnemonic certainly would have helped me.

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[1] Other potential symptoms of “vertebral artery stenosis” include sudden falls, severe headaches, breathing problems, confusion, trouble understanding speech, incontinence, and more.