The American Stroke Association (ASA) and National Stroke Association (NSA) publicize their FAST campaign to get people who are having a stroke to the emergency room quickly. FAST stands for Face (sagging on one side), Arm (weakness in one arm), Speech (impaired), and Time lost is brain lost. However, these are warning signs for strokes that affect the front of the brain.
The ASA estimates that 25% of strokes cut off the blood supply to the back of the brain that produces different symptoms. One type of stroke that affects the back of the brain is a lacunar stroke. A lacunar stroke is caused by cholesterol clogging small blood vessels in the brainstem which connects the brain to the spinal cord. A second type of stroke that affects the back of the brain is stenosis of the vertebral artery. This artery runs up the inside of the neck vertebrae and sends blood to the brainstem. Stenosis narrows the vertebral artery which permanently restricts the amount of blood going to the brainstem. Loss of blood flow to the brainstem can damage the bridge to the cerebellum (pons) which controls balance and coordination.
The scary part about poor balance and coordination is that medical personnel ignore them as signs of a stroke. I immediately went to the emergency room with a sudden onset of impaired balance but a neurologist was not called for two hours. Two years later I again had a second sudden onset of poor balance. A neurologist said this was probably caused by an ear infection. He finally agreed that I had another stroke when I told him I lost the ability to distinguish between hot and cold in my hemiplegic leg and acquired double vision that was confirmed by an optometrist.
Both stroke associations should promote the Five Sudden, Severe Symptoms outlined by the stroke program at Cedars-Sinai Medical Center in Los Angeles. The five symptoms are:
1) sudden severe dizziness, loss of balance, difficulty walking, or incoordination, 2) sudden trouble seeing on one side, 3) sudden severe headache with no known cause, 4) sudden numbness or weakness of the face, arm, or leg on one side of the body, and 5) sudden confusion, trouble speaking, or trouble understanding. What makes these warning signs of a stroke is that they are sudden or severe or both. ASA and NSA need to step up and serve the entire stroke community.