Having a stroke can be a life-changing event with lasting effects. Even after recovering from an initial stroke, it’s important to understand your risks and watch for signs of a recurrent stroke. So how can doctors tell if someone has had a previous stroke?
What happens during a stroke?
A stroke occurs when blood flow to part of the brain is interrupted, causing damage to brain tissue. There are two main types of stroke:
- Ischemic stroke – A blood clot blocks an artery leading to the brain. This accounts for about 87% of all strokes.
- Hemorrhagic stroke – A blood vessel in the brain leaks or ruptures. This accounts for about 13% of strokes.
During a stroke, neurons in the affected area of the brain start to die. The effects of a stroke depend on the location and amount of damage. A minor stroke may cause temporary or minimal symptoms, while a major stroke can lead to significant disability or death.
Signs and symptoms of stroke
Symptoms of stroke come on suddenly and may include:
- Numbness, weakness, or paralysis on one side of the body
- Slurred speech or difficulty understanding speech
- Vision problems in one or both eyes
- Dizziness or loss of coordination and balance
- Severe headache with no known cause
The FAST acronym helps summarize some of the most common symptoms:
- Face drooping on one side
- Arm weakness or numbness on one side
- Speech difficulty
- Time to call 911 if any symptoms are present
Anyone experiencing signs of a stroke should seek immediate emergency care to prevent permanent disability or death.
How doctors diagnose a previous stroke
During a medical evaluation, doctors use several methods to determine if someone has had a prior stroke, including:
Medical history
Taking a full medical history helps identify risk factors for stroke, such as high blood pressure, heart disease, or diabetes. Doctors will ask about any previous strokes, head injuries, or neurological symptoms.
Physical examination
An exam provides vital signs and assesses neurological function. Doctors check for any paralysis, numbness, or vision issues that may indicate a previous stroke.
Brain imaging
Techniques like magnetic resonance imaging (MRI) and computed tomography (CT) scans allow doctors to visualize the brain. They can detect signs of old strokes, such as:
- Loss of brain volume
- Areas of dead tissue
- Damage to gray and white matter
Additional tests
Other assessments that may help diagnose a past stroke include:
- Carotid ultrasound to see blockages in neck arteries
- Echocardiogram to examine the heart for clots
- Blood tests to assess risk factors like cholesterol
Long-term effects of stroke
The brain has a limited ability to recover after stroke damage. Effects vary but can include:
- Paralysis – Inability to move parts of the body due to muscle and nerve damage.
- Aphasia – Impaired ability to understand or express speech.
- Memory loss – Difficulty learning and recalling information.
- Emotional problems – Depression, anxiety, personality changes.
- Pain – Headaches, numbness, tingling, central pain syndrome.
- Fatigue – Feeling exhausted and weak.
Those who survive a major stroke often face long-term disability. However, rehabilitation can help regain some lost abilities.
Risk of recurrent stroke
Someone who has had a stroke is at high risk of having another one. According to the American Stroke Association, 25% of people recovering from their first stroke will have another stroke within 5 years.
The risk is highest within the first 30 days after stroke. But even years later, the chance of recurrence remains elevated compared to the general population.
Factors that increase recurrent stroke risk
- Older age
- High blood pressure
- Diabetes
- Heart disease
- Smoking
- Obesity
- Physical inactivity
- Unhealthy cholesterol levels
Doctors work to control these risk factors through medications, lifestyle changes, surgery, or other treatments.
Warning signs of another stroke
Seek emergency care if you experience any new or recurring stroke symptoms, such as:
- Numbness in the face, arm, or leg
- Confusion
- Trouble seeing out of one or both eyes
- Slurred speech
- Dizziness or loss of balance
- Severe headache
Calling 911 at the first sign of a stroke can prevent disability and save lives.
Reducing your risk of further strokes
While you can’t undo a past stroke, many steps help lower your risk of having another one, including:
- Taking medications as prescribed to control conditions like high blood pressure and diabetes.
- Quitting smoking and limiting alcohol intake.
- Eating a diet focused on whole grains, vegetables, fruits, and lean proteins.
- Exercising for 30 minutes on most days.
- Achieving and maintaining a healthy body weight.
- Managing stress through yoga, meditation, or other relaxation techniques.
Doctors may also recommend surgery or procedures like carotid endarterectomy or stenting to open blocked neck arteries and improve blood flow to the brain.
Conclusion
Doctors can identify previous strokes through medical history, physical examination, brain imaging, and other tests. People who have had a stroke are at high risk for another one, but making lifestyle changes and following doctor’s recommendations can help prevent recurrence.
Seeking immediate treatment when stroke symptoms appear allows the best chance of recovery and prevention of long-term disability. Stroke can happen again, so being aware of the signs and minimizing your risk factors are key to staying healthy after stroke.