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Stroke: the FAST signs and why every minute matters

Learn the FAST signs of stroke, why fast hospital care helps save brain cells, what to do in an emergency, which warning signs need urgent care, and which doctor to see.

A stroke happens when the blood supply to part of the brain is suddenly cut off, or when a blood vessel in the brain bleeds. The brain then does not get enough oxygen, and brain cells are damaged. The World Health Organization (WHO) says a suspected stroke should be treated as a health emergency, and fast care is essential. Knowing the signs helps you act quickly.

What is a stroke?

There are two main types, plus a warning event:

  • Ischaemic stroke (say “is-KEE-mik”): a blood clot blocks a blood vessel in the brain. This is the more common type. In Bangladesh’s nationwide survey, more than three in four people with stroke had this type.
  • Haemorrhagic stroke (say “hem-o-RAJ-ik”): a blood vessel in the brain bursts and bleeds.
  • Transient ischaemic attack (TIA), often called a “mini-stroke”: the symptoms are the same as a stroke, but they last only a few minutes or hours. The NHS says a TIA is a warning sign that a full stroke may follow soon.

WHO advises an urgent brain scan, such as a CT or MRI scan, when a stroke is suspected. The scan shows which type of stroke it is. This matters because the two types are treated differently.

How common is stroke?

Worldwide, the WHO stroke fact sheet (December 2025) reports that in 2021 stroke was the third leading cause of death and disability combined. There were 11.9 million new cases that year. WHO also predicts that 1 in 4 adults will have a stroke in their lifetime.

In Bangladesh, the first nationwide survey of stroke was published in 2022, using data collected in 2018. It found about 11 people with stroke in every 1,000. Rates were much higher in older people and in men, and highest in Mymensingh division. A review that combined several Bangladeshi studies, published in 2024, found a similar figure: about 1.1% of the population.

The FAST signs

Stroke symptoms start suddenly. The easiest way to remember the main ones is the word FAST, used by the UK’s National Health Service (NHS):

Letter What to check What you may see
F – Face Ask the person to smile. One side of the face droops, or it is hard to smile.
A – Arms Ask them to lift both arms. They cannot fully lift both arms, or one arm is weak or numb.
S – Speech Ask them to speak. Speech is slurred or sounds confused, or they cannot understand you.
T – Time Time to get emergency help. If you see any one of these signs, get emergency help immediately, and note the time the symptoms started.

The US Centers for Disease Control and Prevention (CDC) adds two more letters to make BE FAST: B for sudden loss of balance or dizziness, and E for sudden eye or vision problems.

Other sudden symptoms

The NHS lists these other symptoms of stroke:

  • Weakness or numbness down one side of the body
  • Blurred vision or loss of sight in one or both eyes
  • Trouble speaking or thinking of words
  • Confusion and memory loss
  • Feeling dizzy or falling over
  • A severe headache
  • Feeling sick or vomiting

NHS England stresses that just one sign, such as a weak arm, is enough to treat it as an emergency.

Why every minute matters

NHS England (November 2024) says a person having a stroke may lose around two million brain cells every minute. The sooner a person is diagnosed and treated, the more of the brain can be saved.

WHO says clot-busting treatment for the clot type of stroke must be given within hours of the first symptoms. The CDC says the treatments that work best are available only if the stroke is recognised and diagnosed within 3 hours of the first symptoms. People who arrive late may no longer be able to have them. Delays happen everywhere: NHS data for 2023–24 showed that people in England waited 88 minutes on average between their first symptom and calling for help.

Do not wait to see if symptoms pass. The NHS says to get emergency help even if the symptoms have stopped.

What to do if you suspect a stroke

  1. Act immediately, even if the symptoms seem mild or have stopped.
  2. Note the time the symptoms started. Doctors need this to decide on treatment.
  3. Get to a hospital emergency department quickly, ideally one that can do a CT scan of the brain. Call for an ambulance if you can. The person having the stroke should not drive themselves.
  4. Leave treatment to the hospital team. A stroke may be caused by a clot or by bleeding. The right treatment depends on which type it is, and only a scan can show this.
  5. Bring information, such as a list of the person’s current medicines and any reports about blood pressure, diabetes or heart problems.

How stroke is treated

At the hospital, doctors examine the person and arrange an urgent brain scan. According to WHO, treatment then depends on the type of stroke:

  • Clot (ischaemic) stroke: doctors may use a “clot-busting” treatment called thrombolysis. It must be given as soon as possible, within hours of symptoms starting. Some people may also have a thrombectomy, a procedure to remove the clot. Whether this is suitable depends on how severe the stroke is and where it is. WHO notes that these treatments are not available everywhere.
  • Bleeding (haemorrhagic) stroke: care includes controlling blood pressure, intensive care in a specialist stroke unit, and sometimes surgery.

WHO says that care in a specialist stroke unit with rehabilitation services improves recovery and lowers the risk of death. The treating doctor decides which treatment is right for each person.

Warning signs that need urgent care

Go to an emergency department straight away if someone has:

  • Any FAST sign: face drooping, arm weakness or speech problems
  • Sudden weakness or numbness on one side of the body
  • Sudden loss of vision, balance or coordination
  • A sudden, severe headache with no known cause, or sudden confusion
  • Sudden drowsiness, disorientation or memory loss
  • Stroke-like symptoms that went away within minutes or hours. This may have been a TIA. It still needs urgent medical assessment, because a full stroke may follow.

Who is at risk?

Stroke becomes more likely as people get older. WHO names high blood pressure as the leading cause of stroke. People with high blood pressure have nearly three times the risk of stroke of people without it.

Other risk factors listed by WHO include:

  • Smoking and other tobacco use, and second-hand smoke
  • Diabetes and high cholesterol
  • Being overweight and not being physically active
  • A diet high in salt and low in fruit and vegetables
  • Harmful use of alcohol, use of illegal drugs, and air pollution
  • Heart conditions such as atrial fibrillation (an irregular heartbeat) or heart failure, long-term kidney disease, and a previous stroke

WHO says you can lower your risk by keeping blood pressure under control, not using tobacco, avoiding second-hand smoke, limiting alcohol, and managing conditions such as diabetes and high cholesterol. If you have any of these conditions, talk to your doctor about how best to manage them.

Which doctor should you see?

In an emergency, do not wait for a specialist appointment. Go directly to a hospital emergency department.

After the emergency, or for prevention, these doctors are usually involved:

  • Neurologist: a doctor for brain and nerve conditions. Neurologists lead stroke diagnosis and care. Anyone who may have had a TIA should see a specialist urgently.
  • Neurosurgeon: a brain surgeon, sometimes needed for bleeding strokes.
  • Physical medicine and rehabilitation specialist, working with physiotherapists, occupational therapists and speech and language therapists: they help people regain movement, daily skills, speech and swallowing.
  • Medicine specialist (internist): to manage blood pressure, diabetes and cholesterol in the long term.
  • Cardiologist: a heart specialist, if a heart rhythm problem or other heart disease may have caused the stroke.

Ask the care team how the family can help with rehabilitation at home.

Sources

This article is for general information and does not replace advice from a doctor. If you think someone is having a stroke, seek emergency help now.

Find a doctor

Browse Neurology doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.

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