What other conditions can be mistaken for a stroke?
Symptoms — Stroke
Even if the symptoms disappear while you’re waiting for the ambulance, it’s still important to go to hospital for an assessment.
After an initial assessment, you will be referred to a specialist for further tests to help determine the cause of the stroke. You should be referred to see a specialist within 24 hours of the start of your symptoms. Treatment can also begin if necessary.
Symptoms of a stroke that disappear quickly and in less than 24 hours may mean you had a transient ischaemic attack (TIA).
These symptoms should also be treated as a medical emergency to reduce the chances of having another stroke.
Recognising the signs of a stroke
The signs and symptoms of a stroke vary from person to person, but usually begin suddenly.
As different parts of your brain control different parts of your body, your symptoms will depend on the part of your brain affected and the extent of the damage.
The main stroke symptoms can be remembered with the word FAST:
- Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.
- Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
- Time – it’s time to dial 999 immediately if you notice any of these signs or symptoms.
It’s important for everyone to be aware of these signs and symptoms, particularly if you live with or care for a person who is in a high-risk group, such as someone who is elderly or has diabetes or high blood pressure.
Other possible symptoms
Symptoms in the FAST test identify most strokes, but occasionally a stroke can cause different symptoms.
Other signs and symptoms may include:
- complete paralysis of 1 side of the body
- sudden loss or blurring of vision
- being or feeling sick
- difficulty understanding what others are saying
- problems with balance and co-ordination
- difficulty swallowing (dysphagia)
- a sudden and very severe headache resulting in a blinding pain unlike anything experienced before
- loss of consciousness
But there may be other causes of these symptoms.
Transient ischaemic attack (TIA)
The symptoms of a transient ischaemic attack (TIA), also known as a mini-stroke, are the same as a stroke, but tend to only last between a few minutes and a few hours before disappearing completely.
Although the symptoms do improve, a TIA should never be ignored as it’s a serious warning sign of a problem with the blood supply to your brain.
It means you’re at an increased risk of having a stroke in the near future.
It’s important to phone 999 immediately and ask for an ambulance if you or someone else have TIA or stroke symptoms.
If a TIA is suspected, you will be offered aspirin to take straightaway. This helps to prevent a stroke.
Even if the symptoms disappear while you’re waiting for the ambulance to arrive, an assessment in a hospital should still be done. You should be referred to see a specialist within 24 hours of the start of your symptoms.
If you think you have had a TIA before, but the symptoms have since passed and you did not get medical advice at the time, make an urgent appointment with a GP.
They can refer you for a hospital assessment, if appropriate.
Page last reviewed: 13 September 2022
Next review due: 13 September 2025
How is stroke diagnosed?
Stroke is a medical emergency. Tests for stroke usually start when you’re in the ambulance, before you get to the hospital. This is one reason why it’s important to call 911 for a stroke, rather than have someone drive you to the hospital. The goals of the tests are to figure out whether you’ve had a stroke, what type of stroke you’ve had, and what caused the stroke. This will help your doctors plan your treatment.
Physical and neurological exam
After you call 911 and the ambulance arrives, an ambulance worker will start the stroke exam. A doctor will continue the exam at the hospital. The ambulance worker or doctor will:
- Ask you or a family memberabout your symptoms and medical history.
- Do a physical exam. This includes taking your blood pressure and checking for mental alertness, numbness or weakness, or trouble speaking, seeing, or walking.
- Do a neurological exam. This test checks how well your nervous system is working to show whether you have had a stroke. In this exam, the doctor will ask you questions, test your reflexes, and ask you to do simple actions. Each part of the exam tests a different part of your brain. This test can show how serious your stroke was and where in your brain the stroke might have happened.
Imaging tests for stroke
At the hospital, you will probably get at least one imaging test that allows your doctor to see inside your brain, see how much damage was done and where the stroke happened. Some imaging tests you may get include:
- Computed tomography (CT) scan. A CT scan uses X-rays to take pictures of the brain. A CT scan of the head is usually one of the first tests used for a stroke. A CT scan can show bleeding in the brain or damage to brain cells. The CT scan also can find other problems that can cause stroke symptoms.
- Magnetic resonance imaging (MRI). MRI uses a strong magnet and radio waves to make pictures of the brain. MRI shows brain changes caused by stroke sooner than a CT scan. MRI also can show any bleeding or blood flow problems. It can rule out other problems such as tumors that can cause symptoms similar to a stroke.
- CT or MR angiogram. An angiogram is an X-ray movie of the blood vessels and blood flow through them. A dye is injected into the veins to show a detailed picture of the blood vessels after a stroke. A CT angiogram is used with a CT scanner, and a MR angiogram is used with an MRI.
- Carotid ultrasound. Carotid ultrasound is a test that uses sound waves to create pictures of your carotid arteries, which supply blood to your brain. Often used with a CT or MR angiogram, the carotid ultrasound shows whether plaque has built up in your arteries and is blocking blood flow to your brain.
- Trans-cranial Doppler (TCD) ultrasound. Doppler ultrasound is a test that uses sound waves to measure blood flow. Also used with a CT or MR angiogram, the TCD helps your doctor find out which artery in your brain is blocked.
- Electroencephalogram (EEG). An EEG is done less often. This test records electrical activity in the brain to be sure your stroke symptoms are not caused by a seizure. Seizures can cause symptoms like movement problems and confusion. These can be mistaken for the symptoms of stroke or transient ischemic attack (TIA). During this test, you’ll have sticky electrodes placed on your head, with wires attached to a machine. The machine records the electrical signals picked up by the electrodes.
- Electrocardiogram (ECG or EKG). This test detects and records your heart’s electrical activity. It can help your doctor find out if atrial fibrillation caused the stroke. An ECG can be done during physical activity to monitor your heart when it is working hard.
Blood tests for stroke
There is no blood test that can diagnose a stroke. However, in the hospital, your doctor or nurse may do a series of blood tests to learn the cause of your stroke symptoms:
- Complete blood count (CBC). A CBC measures the overall health of your blood and helps diagnose infection, anemia, clotting problems, or other blood problems.
- Serum electrolytes. This test looks at substances in your blood that carry an electric charge, called electrolytes. An electrolyte problem can cause stroke-like symptoms such as confusion or muscle weakness. Electrolytes also show whether you are dehydrated, which can cause confusion or tiredness. This test can also show whether you have kidney problems, which can change the stroke tests and treatments your doctor does.
- Blood clotting tests. These tests measure how quickly your blood clots. It is also called a coagulation panel. If your blood clots too quickly, your stroke may have been caused by a clot (ischemic stroke). If your blood clots too slowly, your stroke may have been caused by bleeding (hemorrhagic stroke).
- Heart attack tests. Your doctor may also order tests to see whether you have had a heart attack. Some women with stroke symptoms also have heart attack symptoms. Some heart problems can lead to a stroke.
- Thyroid tests. Your doctor may measure your thyroid hormone levels with a blood test. Having hyperthyroidism raises your risk of atrial fibrillation, which can lead to stroke.
- Blood glucose. This test measures the glucose (sugar) in your blood. Low blood sugar is a common complication of diabetes treatments. Low blood sugar can cause symptoms of a stroke, even when it’s not a stroke.
- Cholesteroltests. This test examines whether high blood cholesterol might have led to your stroke.
- C-reactive protein test and blood protein test. These tests look for substances in your blood that your body releases in response to swelling or inflammation. Damage to arteries is one cause of inflammation. Your doctor might order these tests to understand your stroke risk better and to determine how to treat your stroke.
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7 Common Stroke Mimics That Look Like You’re Having a Stroke
When you’re having a stroke, every minute counts. Fast treatment can lessen the brain damage that strokes can cause and improve survival rates, while lowering disability rates. In fact, many of the most effective treatments are only available if the stroke is diagnosed within three hours of symptoms.
A stroke is a serious medical condition that occurs when the blood supply to any region of the brain is reduced or blocked completely. Strokes are the No. 5 cause of death and a leading cause of disability in the United States, according to the American Stroke Association. A stroke can happen to anyone, at any age, so it’s important to know the warning signs.
If you’re experiencing any of these common stroke symptoms, remember BE FAST and call 9-1-1.
- Balance – Dizziness, trouble walking, loss of balance and coordination
- Eyes — Trouble seeing in one or both eyes
- Face – Facial drooping or severe headache with no known cause
- Arms — Numbness or weakness in the arms
- Speech — Slurred speech, trouble talking or understanding speech
- Time – to call 911
The question is how do you know if you’re having a stroke or something else? There are several conditions that can cause symptoms similar to a stroke, known as stroke mimics. A seizure, high blood pressure and even migraine headaches can cause sudden numbness or weakness.
Summa Health sheds light on 7 common stroke mimics and what symptoms to watch for so you can act fast to identify the cause. Just remember, while it’s helpful to be aware of stroke mimics, keep this in mind: A stroke is not a wait-and-see kind of condition. When in doubt, call an ambulance immediately and let medical professionals determine what’s causing your severe symptoms.
- Seizures Seizures are episodes of abnormal brain activity caused by a sudden, uncontrolled electrical disturbance in the brain. While most people are familiar with the most severe seizure that causes unconsciousness and violent body shakes, there are many other types of seizures that mimic stroke symptoms, such as weakness in one arm or leg, numbness, tingling, temporary confusion, or loss of consciousness.
- Migraine headaches Most migraine headaches involve severe pain in the head and neck. However, some migraines can mimic a mini-stroke with symptoms such as, temporary facial paralysis, blurred vision, slurred speech, or weakness or numbness in the arms or legs.
- High or low blood sugar Too much or too little sugar in your blood can cause your brain to misfire. Low blood sugar can cause symptoms similar to a stroke, such as dizziness, shakiness, irregular heartbeat or severe headache. High blood sugar, on the other hand, can cause blurred vision, weakness, severe headache and feeling out of it, making it difficult to distinguish high blood sugar from a stroke.
- Bell’s Palsy Sudden facial weakness can be a sign of Bell’s Palsy, a condition caused by damaged nerves that help control your facial muscles. Symptoms can include mouth drooping, drooling or trouble closing one eye. Facial weakness can be a very concerning symptom, as it is one of the hallmark signs of a stroke.
- Brain tumor A brain tumor is a growth of abnormal cells in the brain. Depending on where it is located, a brain tumor can cause a whole host of different symptoms, some similar to a stroke. You may lose coordination, have trouble speaking or seeing, have weakness in your arms or legs, or develop confusion.
- Multiple sclerosis Multiple sclerosis is a chronic condition that occurs when the immune system attacks nerve cells in your brain and spinal cord. This can cause numbness, tingling, muscle weakness, vision loss and impaired coordination.
- High blood pressure
High blood pressure emergencies can cause dizziness, numbness, tingling sometimes weakness, as well. If your blood pressure is 180/120 or higher and you are experiences the symptoms listed above, you should visit the emergency room.
What should you do if you develop stroke-like symptoms?
Typically when a person is suffering from a stroke, symptoms are abrupt and appear simultaneously. In many cases, symptoms of a stroke mimic tend to come on gradually. A head CT scan or MRI is the best way to rule out a stroke.
That’s why when in doubt, never delay treatment. Get to the emergency room for a medical evaluation. It’s important to call an ambulance so medical staff can begin diagnosis and treatment on the way to the hospital. The consequences of a real neurological emergency can be quite significant. That’s why any stroke-like symptoms should be taken seriously with quick action to save a life — perhaps your own.
To schedule an appointment with Summa Health’s award winning neurology care team, call 877.739.1687 or visit summahealth.org/brain.