A stroke can change a person's life within minutes, making it one of the most time-sensitive medical emergencies. It occurs when a blood vessel supplying the brain becomes blocked or ruptures, interrupting the delivery of oxygen and nutrients to brain tissue. Brain cells begin to suffer damage rapidly, and prolonged interruption of blood flow can lead to permanent disability, paralysis, difficulties with speech and movement, or even death. Despite the urgency, many people fail to recognise the early symptoms or mistake them for temporary weakness, exhaustion or dizziness. This lack of awareness can delay treatment and reduce the chances of recovery.
Recognising a stroke early and acting immediately can significantly influence the outcome. The B.E. F.A.S.T. method helps people identify common warning signs. B refers to a sudden loss of Balance, E to changes in the Eyes or vision, F to facial drooping, A to weakness in an Arm or leg, S to difficulty Speaking or understanding speech, and T to Time to seek emergency medical attention. Sudden numbness on one side of the body, confusion, difficulty walking and an unusually severe headache may also indicate a stroke. These symptoms should never be dismissed, even if they resolve on their own. Brief episodes may signal a transient ischemic attack, which requires urgent medical evaluation because it can precede a more serious stroke.
A major challenge in stroke care is the time lost before patients reach an appropriately equipped hospital. Families may wait for symptoms to subside or seek advice from multiple sources before arranging emergency treatment. However, treatment eligibility depends on several factors, including the type of stroke, the time of onset and brain imaging findings. If stroke is suspected, emergency services should be contacted immediately, and the time when the symptoms first appeared or the patient was last known to be well should be recorded. Patients should not be given food, water or medication without medical advice, as swallowing difficulties may be present and the underlying cause of the stroke may not yet be established.
Medical advances have improved the ability to treat acute stroke and restore blood flow in appropriately selected patients. Intravenous thrombolysis uses clot-dissolving medicines such as alteplase or tenecteplase to treat certain ischemic strokes. These medicines are generally considered within 4.5 hours of symptom onset, following clinical assessment and appropriate imaging. Timely administration is important because restoring circulation early can limit the extent of brain injury.
Mechanical thrombectomy has further transformed the treatment of selected patients with large-vessel occlusion strokes. In this minimally invasive procedure, a specialist introduces a catheter through an artery, usually in the wrist or groin, and navigates it to the blocked vessel in the brain. A stent retriever or aspiration catheter is then used to remove the clot and restore blood flow. In carefully selected patients, advanced imaging can help determine whether thrombectomy may be beneficial up to 24 hours after the patient was last known to be well. However, this extended treatment window should never be interpreted as a reason to delay seeking care.
Advanced imaging techniques, including CT angiography, CT perfusion and MRI, play an important role in identifying blocked arteries, assessing the extent of brain injury and guiding treatment decisions. Some eligible patients may receive intravenous thrombolysis before undergoing thrombectomy. When thrombectomy is indicated, the procedure should not be unnecessarily delayed while waiting to assess the effect of the clot-dissolving medicine.
Neurointerventional techniques are also important in managing haemorrhagic strokes and certain underlying vascular abnormalities. When bleeding occurs because of a ruptured brain aneurysm, endovascular coiling and other specialised procedures may be used to secure the affected vessel and reduce the risk of rebleeding. Selected brain arteriovenous malformations and abnormal vascular connections can also be treated through endovascular embolisation, in which specialised materials are used to block or reduce abnormal blood flow. The treatment approach depends on the location and nature of the abnormality. Some patients with bleeding in the brain may additionally require close monitoring, blood pressure management, reversal of certain blood-thinning medicines or surgery to relieve pressure within the skull.
Stroke management does not end with the initial emergency treatment. Coordinated care involving neurologists, neurointervention specialists, neurosurgeons, critical care teams and rehabilitation professionals is essential to address complications and support recovery. Physiotherapy can help improve movement and balance, speech and language therapy can address communication and swallowing difficulties, while occupational therapy can help patients regain independence in everyday activities. The extent of recovery varies from person to person, making individualised treatment and rehabilitation particularly important.
While advanced treatment options have improved outcomes, prevention remains a critical part of reducing the overall burden of stroke. High blood pressure, diabetes, elevated cholesterol, tobacco use, physical inactivity and certain heart conditions can increase the risk. Regular health assessments, appropriate medication, a balanced diet, physical activity and timely management of underlying medical conditions can help reduce this risk. Stroke can affect people across age groups, reinforcing the need for awareness and preparedness among individuals, families and communities.
The upcoming AI & Stroke Summit organised by WeCareStroke, in December is expected to provide an opportunity for medical professionals and other stakeholders to discuss how artificial intelligence and emerging technologies can contribute to stroke detection, clinical decision-making, treatment planning and patient outcomes. As these innovations continue to evolve, the priority must remain ensuring that advances in stroke care translate into timely, accessible and effective treatment for patients. On World Stroke Day, the message is clear: recognise the warning signs, act without delay and remember that every minute can make a difference between recovery and lifelong disability.
