January 1, 2016

The FAST Campaign Is Not Working

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.


  1. FAST works also when the medical staff recognizes it as a stroke. Not all do. My hospital is quick to prescribe ATIVAN for women who present with these signs and stroke symptoms are are cast aside sometime for hours, go figure.

    I like the sudden severe method. It works for all the stroke signs besides diabetes. Mine was attributed to low blood sugar until my blood sugar was normal again. DOH! A waste of precious time and tPa was ruled out because of the time factor.

  2. The FAST campaign is a failure because once in a hospital ER docs have no objective way to diagnose a stroke. Poor planning on whomever designed the FAST campaign.The ASA, NSA and WSO are complete failures.

    1. I think you mean there is no way to detect a stroke in its early stages. We need a blood test like people who have heart attacks have.

  3. YES, YES, EXACTLY!!! I am somewhat surprised and elated to see your inclusion of cavernous angioma, the condition that affected me....and is nearly always disregarded by the neurological community. It took me a year, and countless visits to various specialists to get properly diagnosed and an effective plan purposed. For "us", the neurological community is a complete failure. My situation is not unique! :( My angioma was deep in the basal ganglia, large, and "growing"/bleeding. My initial symptoms were dizziness, vision all messed up, and partial seizures(which I had no idea what was going on at first). To the "experts" I was asymptomatic. No FAST here. And angiomas are benign, "they don't cause symptoms"....I heard that a time too many....morons!! Inner ear, post part depression were the most common misdiagnosises I got. When these clowns don't know something, they shouldn't just try to guess. Send me to someone that knows. Ugh!

  4. When my husband had his stroke in April, he actually had symptoms of a bad flu bug that was going around for hours before we noticed the confusion. At that point I first suspected it was his blood sugar but, suddenly I remembered an email I had read a couple of days prior about the tongue going to the side when stuck out is a new indicator. I had him do it and when it went to the side I realized he was in trouble. He didn't show left sided weakness or drooping in his face until he had been in the hospital 2 days. I am so glad I received that email and now make a point to spread that info.