Stroke, often imagined as a sudden and dramatic event, is one of the most feared medical emergencies worldwide. But what many don’t realise is that the brain often whispers before it screams. Subtle warning signs may appear days or even weeks before a major stroke, and recognising them in time can make the difference between full recovery and lifelong disability.
Every year, World Stroke Day (October 29) serves as a reminder that awareness saves lives. This year’s theme, ‘Know your risk: The hidden warning signs before a stroke strike’, urges people to listen closely to what their body may be trying to tell them.
“We all know the classic BE-FAST symptoms — Balance loss, Eye and vision problems, Facial droop, Arm weakness, and Slurred speech — but there are many other subtle signs people tend to overlook,” says Dr Y Muralidhar Reddy, senior consultant & head, department of neurology, Renova Century Hospitals, Banjara Hills.
These hidden symptoms can include sudden confusion, personality changes, severe headache, numbness on one side, unexplained fatigue, difficulty swallowing, frequent falls, tremors, or even loss of bladder control. “A stroke rarely arrives unannounced. The challenge lies in recognising these whispers before they become a roar,” he adds.
A critical early warning is the Transient Ischemic Attack (TIA), often called a ‘mini-stroke’. TIAs cause temporary symptoms such as weakness, numbness, or blurred vision that resolve within minutes or hours. Many people dismiss them — a dangerous mistake, since one in three individuals who experience a TIA may suffer a major stroke if untreated.
Who’s at risk?
While strokes can happen to anyone, certain groups are more vulnerable. “Older adults above 55, men, and those with a family history of stroke are at higher risk,” says Dr Muralidhar.
Lifestyle diseases amplify this risk. High blood pressure, diabetes, high cholesterol, obesity, smoking, excessive alcohol consumption, heart disease, and sedentary habits are all major contributors. Sleep disorders like sleep apnoea can also increase susceptibility.
According to ICMR data, the nationwide incidence of stroke is estimated between 105 and 152 per 100,000 people annually. In Telangana, the numbers are even more concerning. A rural survey revealed a crude prevalence of 257 per 100,000, with men (344) significantly more affected than women (163).
A recent survey in Hyderabad showed that while 78% of respondents had heard the term ‘brain stroke’, 81% did not know any symptoms, and only 19% could identify even one sign. Shockingly, one in seven stroke patients in Hyderabad are young adults between 25 and 45 years.
Every second counts
“Time lost is brain lost,” warns Dr Muralidhar. “A stroke damages brain tissue, but that loss can be minimised if treatment begins quickly,” he adds.
Dr Sandeep Nayani, consultant neurologist at Apollo Hospitals, Jubilee Hills, explains that the recombinant tissue-plasminogen activator (tPA), a life-saving clot-dissolving drug, must be administered within three hours of symptom onset — and the earlier, the better. “To prevent brain cell death significant enough to cause disability, treatment ideally should begin within 60 minutes,” Dr Sandeep emphasises.
Warning signs like weakness in an arm or leg, slurred speech, vision loss, or sudden dizziness should never be ignored. “If any of these appear, go to a hospital immediately — preferably one equipped with an acute stroke response team,” he advises.
The good news? Most strokes are preventable. Maintaining normal blood pressure, cholesterol, and blood sugar, eating a balanced diet, engaging in regular exercise, avoiding smoking and excessive alcohol, and managing stress can drastically reduce risk.
“Stroke prevention is about consistency — regular check-ups, adherence to prescribed medications, and small daily choices that protect your heart and brain,” says Dr Muralidhar.
Road to recovery
For those who have experienced a stroke, rehabilitation is key. “Half of stroke patients can make a full recovery over months, but many struggle with long-term disability,” notes Dr Sandeep, adding, “Beyond medication, patients need physiotherapy, counselling, and strong family support.”
He advocates for multidisciplinary stroke clinics that include neurologists, physiotherapists, dieticians, and psychologists. “Comprehensive care not only speeds recovery but also educates families and communities. Awareness at the grassroots level can help prevent future strokes,” he adds.
Stroke may strike suddenly, but it rarely comes without warning. By paying attention to subtle changes and by keeping health risks under control, you can protect your most vital organ: your brain.
