What Happens in the Brain During a Stroke
A stroke is a brain attack — the brain's equivalent of a heart attack. It happens when the blood supply to part of the brain is suddenly cut off, so that region stops receiving the oxygen and glucose it needs to survive. Brain cells begin to die within minutes, and unlike some other tissues, they do not grow back. This is why speed is everything.
There are two main types. About 85% of strokes are ischaemic, caused by a clot blocking an artery to the brain. The remaining 15% are haemorrhagic, caused by a blood vessel bursting and bleeding into or around the brain, often linked to uncontrolled high blood pressure. Both are emergencies, but they are treated differently — which is exactly why a scan is done urgently on arrival before any clot-busting drug is given.
The frightening truth is that a stroke usually causes no pain. There is no chest-clutching drama. Instead one side of the body suddenly weakens, the face droops, or speech becomes slurred — and because it does not hurt, families often wait, hoping it will pass. That waiting is what costs brain tissue, independence and lives. Recognising a stroke the moment it starts is a skill every family should have.
FAST — The Four Signs to Recognise Immediately
The simplest, most reliable way to spot a stroke is the FAST test. It takes seconds and needs no equipment. If you see even one of these signs, assume it is a stroke until proven otherwise.
- F — Face drooping. Ask the person to smile. Does one side of the face droop or look uneven? Is the mouth pulled to one side?
- A — Arm weakness. Ask them to raise both arms and hold them up. Does one arm drift down or feel heavy and weak?
- S — Speech difficulty. Ask them to repeat a simple sentence. Are the words slurred, jumbled, or is the person unable to speak or understand you?
- T — Time to call emergency. If any of these signs are present, note the exact time symptoms started and call for help immediately. Time is the single most important factor in the outcome.
You do not need to be certain. You do not need to diagnose the type of stroke — that is the hospital's job. Your only task is to recognise that something is suddenly and seriously wrong, and to act at once. A false alarm is a good outcome; a missed stroke is a tragedy.
Less-Known Stroke Symptoms (Sudden Severe Headache, Vision Loss, Balance Problems)
FAST catches most strokes, but not all. Some strokes — particularly those affecting the back of the brain (the brainstem and cerebellum) — show up differently, and these are the ones most often missed even by doctors. Learn them too:
- Sudden severe headache — 'the worst headache of my life', coming on like a thunderclap, sometimes with vomiting or loss of consciousness. This can signal a bleed on the brain.
- Sudden vision loss — loss of sight in one eye, or loss of one half of the field of vision, or sudden double vision.
- Sudden severe dizziness or loss of balance — being unable to walk or stand, veering to one side, or violent spinning vertigo that comes with any other neurological sign.
- Sudden numbness down one side of the body, or on one side of the face.
- Sudden confusion or difficulty understanding what people are saying.
The common thread is the word sudden. Symptoms that appear abruptly, out of the blue, affecting one side of the body or one function of the brain, should be treated as a stroke until a doctor says otherwise. When these appear together with FAST signs, there is no room for doubt.
The Golden Hours — Why Time Matters More Than Anything
In stroke medicine there is a simple, sobering phrase: time is brain. Every minute that an ischaemic stroke goes untreated, roughly 1.9 million brain cells die. An hour of delay can age the brain by years. This is why stroke is one of the most time-critical emergencies in all of medicine.
The key treatment for an ischaemic (clot) stroke is thrombolysis — a clot-busting drug that can dissolve the blockage and restore blood flow. But it only works, and is only safe, within about 4.5 hours from the moment symptoms began. After that window the drug is unlikely to help and more likely to cause harm. For certain large clots, a procedure called mechanical thrombectomy (physically pulling the clot out) extends the window in selected patients — but again, the sooner it is done, the better the result.
This is the whole reason FAST matters so much. A stroke that is recognised in minutes and reaches hospital within an hour can often be reversed, leaving the person to walk out of the ward. The very same stroke, recognised six hours later, may leave the person paralysed for life. The difference is not the severity of the stroke — it is how fast the family acted.
What to Do When You Suspect Stroke
If you suspect a stroke, act calmly and immediately. Follow these steps:
- Call for emergency help at once — call Gini's 24/7 emergency line +91 82888 43800 or arrange the fastest possible transport to a hospital with a CT scanner and stroke care.
- Note the exact time symptoms started — or the last time the person was seen completely normal. This single piece of information decides whether clot-busting treatment can be given, so it is vital.
- Do NOT wait to 'see if it improves', do not give aspirin or any other medicine on your own (a bleeding stroke can be made worse), and do not offer food or water, as swallowing may be unsafe.
- Keep the person safe and comfortable — lie them on their side if drowsy or vomiting, loosen tight clothing, and stay with them.
- Gather essentials for the hospital — a list of their medicines, known conditions (diabetes, blood pressure, atrial fibrillation), and any blood thinners they take.
At Gini Advanced Care Hospital, the emergency and critical-care teams are geared to move fast — rapid assessment, an urgent CT scan, and thrombolysis where appropriate — because in stroke, every minute saved is brain saved.
TIA — The Mini-Stroke That Predicts a Bigger One
Sometimes stroke symptoms appear and then vanish completely within minutes to an hour or so. The face droop lifts, the arm strength returns, speech comes back. It is tempting — and dangerous — to feel relieved and forget about it. This is a transient ischaemic attack (TIA), or 'mini-stroke', and it is one of medicine's most important warning signs.
A TIA means a clot briefly blocked an artery and then cleared before permanent damage was done. But it reveals that the underlying plumbing is unstable. A significant proportion of people who have a TIA go on to have a full, disabling stroke within days to weeks — and the highest risk is in the first 48 hours. A TIA is therefore not a lucky escape to be shrugged off; it is a golden opportunity to prevent a major stroke.
If you or a family member has had stroke-like symptoms that came and went, see a neurologist urgently — the same day, not next week. Quick assessment, blood thinners or other clot-prevention treatment, blood-pressure and cholesterol control, and checks for a heart-rhythm problem (atrial fibrillation) or narrowed neck arteries can dramatically cut the chance of the bigger stroke that a TIA is warning you about.
Stroke Prevention — After the First Event
Surviving a stroke or a TIA is the moment to make sure it never happens again — and most second strokes are preventable. Prevention rests on controlling the risk factors that damage blood vessels, most of which are extremely common in Punjab and North India.
- Blood pressure — high blood pressure is by far the biggest single risk factor for stroke. Keeping it well controlled is the most powerful thing you can do.
- Diabetes — good long-term sugar control protects both large and small brain vessels. Gini's neurology and endocrinology teams manage this together.
- Atrial fibrillation — an irregular heartbeat that throws clots to the brain; it needs proper blood-thinning treatment, not just aspirin.
- Cholesterol — statins reduce the risk of a further stroke.
- Smoking and tobacco (including gutka and khaini) — stopping is one of the single most effective steps.
- Lifestyle — regular activity, a healthier diet lower in salt and fried food, weight control and limiting alcohol.
After a stroke, patients also need rehabilitation — physiotherapy, speech therapy and occupational therapy — to recover function, alongside a clear medication plan. Dr. Iqbal Singh and the Gini team build this plan with each family, so recovery and prevention go hand in hand.