Stroke Warning Signs: FAST Symptoms, What to Do and How to Prevent a Stroke
Last updated 2026-10-24 · 887 words · Medically reviewed by: [Reviewer name, SLMC reg. no.]
A stroke happens when blood flow to part of the brain is blocked or a blood vessel in the brain bursts. Brain cells begin to die within minutes, so a stroke is a medical emergency. It is one of the leading causes of death and long-term disability worldwide, and the single biggest cause is untreated high blood pressure. The most important message is simple: recognise the signs, act immediately, and go to hospital.
The FAST test
FAST is an easy way to remember the main warning signs:
- F - Face: Ask the person to smile. Does one side of the face droop or feel numb?
- A - Arms: Ask them to raise both arms. Does one arm drift down or feel weak?
- S - Speech: Is speech slurred, strange or confused? Can they repeat a simple sentence?
- T - Time: If you see any of these signs, call for an ambulance immediately (1990 in Sri Lanka) and note the time symptoms began.
A longer version, BE-FAST, adds B - Balance (sudden loss of balance or coordination) and E - Eyes (sudden vision loss or double vision).
Other symptoms
- Sudden confusion or trouble understanding others
- Sudden severe headache with no known cause, sometimes with vomiting
- Sudden difficulty walking, dizziness or feeling the room spin
- Numbness or weakness on one side of the body
- Trouble swallowing
Symptoms come on suddenly. They may be mild and may improve, but you should still seek emergency care.
Types of stroke
- Ischaemic stroke (about 85%): a clot blocks an artery supplying the brain. Clots may form in narrowed arteries or travel from the heart, especially in people with atrial fibrillation (an irregular heartbeat).
- Haemorrhagic stroke: a blood vessel bursts and bleeds into or around the brain, often because of very high blood pressure.
- Transient ischaemic attack (TIA): a temporary blockage with symptoms lasting minutes to hours. About 1 in 5 people with a TIA may have a stroke within weeks if not treated.
A brain scan (CT or MRI) is needed to tell the types apart, because treatment is completely different.
What to do if you suspect a stroke
- Call for emergency help immediately (1990 in Sri Lanka) or get to the nearest hospital with a CT scanner and stroke care. Do not wait to see if symptoms pass.
- Note the time symptoms started, or when the person was last seen well. Doctors need this to decide on treatment.
- Keep the person safe. Lay them down with head slightly raised, or on their side if drowsy or vomiting.
- Do not give food, drink or medicine, including aspirin, until a doctor has checked, because swallowing may be unsafe and aspirin is harmful in bleeding strokes.
- Loosen tight clothing, and stay with them. Bring their medicine list.
- Do not drive yourself if you are the one having symptoms.
Treatment in hospital
- Thrombolysis: medicine that dissolves the clot, given within about 4.5 hours of symptom onset in suitable patients.
- Thrombectomy: a procedure to remove a large clot, available in specialised centres, and sometimes possible many hours after onset.
- Bleeding strokes: blood pressure control, reversal of blood thinners, and sometimes surgery.
- Stroke unit care, rehabilitation, speech therapy, physiotherapy and secondary prevention medicines (aspirin or similar, statins, blood pressure medicines).
Who is at risk?
- High blood pressure (the biggest risk factor)
- Diabetes and high cholesterol
- Smoking and heavy alcohol use
- Atrial fibrillation and other heart disease
- Obesity, inactivity and a poor diet
- Age over 55, family history, previous stroke or TIA
- Sleep apnoea
Asians have a relatively high rate of stroke, particularly from bleeding and from narrowing of brain arteries, so blood pressure control is vital.
How to prevent a stroke
- Check your blood pressure regularly and keep it below your target. See how to lower high blood pressure.
- Control diabetes and cholesterol. Read how to lower cholesterol.
- Stop smoking and limit alcohol.
- Eat less salt, more vegetables, fruit, pulses, fish and whole grains.
- Stay active: at least 150 minutes of brisk activity a week and a healthy weight.
- Ask about an irregular pulse. Atrial fibrillation can be treated with blood thinners that cut stroke risk by about two-thirds.
- Take preventive medicines exactly as prescribed after a TIA or stroke.
Recovery after stroke
Rehabilitation starts early and may continue for months or years. Many people regain function, especially in the first three to six months. Depression, fatigue and fear of another stroke are common, so family support and counselling matter. Ask your doctor about driving, return to work and home safety.
When to see a doctor
Call emergency services immediately for any sudden stroke symptom. See your doctor promptly if you have had a TIA, if your blood pressure is high, or if you have a family history of stroke and want a risk check.
References
- World Stroke Organization: stroke fact sheet and global stroke services guidelines
- American Heart Association / American Stroke Association: stroke warning signs and guidelines for early management
- NICE guideline NG128: stroke and TIA in over 16s
- World Health Organization: cardiovascular diseases fact sheet
Frequently asked questions
What are the first signs of a stroke?
Sudden face drooping, weakness or numbness in one arm or leg, slurred or confused speech, loss of vision, severe dizziness or loss of balance, or a sudden severe headache.
How long do I have to get treatment?
Clot-busting medicine works best within about 4.5 hours of the start of symptoms, and some patients can have clot removal procedures later. Every minute counts, so go to hospital at once.
Can a stroke happen without pain?
Yes. Most strokes are painless, which is why people often delay seeking help. A sudden severe headache can occur with bleeding strokes.
What is a mini-stroke?
A transient ischaemic attack (TIA) causes stroke symptoms that disappear within minutes to hours. It is a warning that a major stroke may follow and needs urgent assessment.
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