Stroke is the second leading cause of death worldwide, claiming around 6 million lives annually. However, nearly a third of cases go unnoticed in time — people often attribute the warning signs to fatigue, stress, or age-related changes. While classic symptoms like facial asymmetry and speech difficulties are well-known, numerous atypical manifestations are often overlooked. Recognizing these hidden signs within the first 3-6 hours of a stroke can increase survival and full recovery chances by five times.
Unexplained Dizziness
One of the most insidious symptoms is sudden dizziness without any obvious cause. Unlike typical vertigo, which occurs when standing up or moving, stroke-related dizziness happens at rest and is often accompanied by the sensation of the room “spinning.”
A study conducted by the American Neurological Association found that 45% of patients who experienced a microstroke had dizziness episodes lasting 10-15 minutes in the days leading up to a serious stroke. A particularly alarming sign is when dizziness is accompanied by nausea and difficulty focusing on objects, but without nystagmus (involuntary eye movements), which is typically associated with vestibular problems.
Vision Disturbances
Another frequently ignored signal is vision disturbances. A stroke in the occipital lobe of the brain can cause a “dropout” effect, where the person can’t see the right or left side of their visual field. Some patients describe it as a “sudden shadow” or “blurred vision” in one eye. A key feature of this symptom is that it doesn’t correct with glasses and is not accompanied by pain, distinguishing it from eye-related issues.
The journal Stroke published a study revealing that 23% of people who suffered ischemic strokes experienced brief (5-10 minute) episodes of vision loss a week before the event.
Sudden Loss of Skills
An unusual but significant symptom can be a sudden loss of skills. A person might forget how to use the microwave or tie their shoes, even though their memory of events and faces remains intact. This manifestation, known as apraxia (the loss of complex motor skills), often occurs with damage to the parietal lobe. It is especially concerning if these episodes recur and last more than 10 minutes.
Experts at the Mayo Clinic included this symptom in the list of “transient ischemic attacks” — precursors to a full-blown stroke.
Altered Temperature Perception
This is a rare but telling symptom. Some patients report feeling that objects have become “inappropriately” hot or cold in the hours before a stroke. For example, tap water may feel scalding. This is related to damage to the thalamus, the “thermostat” of the brain.
An important distinction: this condition is not accompanied by a real change in body temperature and does not respond to fever-reducing medications.
Psychological Changes
Psychological changes are often mistaken for fatigue or depression. Sudden apathy in an active person or, conversely, unusual excitement can indicate disrupted blood flow to the frontal lobes. A particularly telling combination is these mood changes with a loss of smell or the sudden appearance of a “metallic” taste in the mouth.
A study conducted by Oxford University researchers showed that 18% of patients with a stroke in the anterior cerebral artery region had sudden, unmotivated mood swings 24 hours before the event.
Why Are These Symptoms Overlooked?
The problem lies in their “undramatic” nature — unlike the classic “face-arm-speech” symptoms, they don’t immediately stand out to others. Furthermore, many of them are transient — they appear for 10-15 minutes and then disappear, creating a false sense of well-being. Neurologists refer to this as the “missed time syndrome” — when a patient seeks help only a day after the first signs, by which time thrombolytic therapy is no longer effective.
What to Do if You Notice Atypical Symptoms?
Even one of these signs is enough to perform a simple test: ask the person to smile, raise both arms, and repeat a simple phrase. You should also measure blood pressure on both arms (a difference of more than 15 mmHg is a red flag). It’s crucial to call an ambulance without delay.
Remember, with a stroke, time is critical. Every 15 minutes of delay reduces the chances of recovery by 4%. Modern treatment protocols allow for full recovery in 70% of patients if help is provided within the first 4.5 hours of the stroke.
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