Strokes aren’t just for the elderly: how to spot the signs and act fast

Strokes are terrifying not just because of their suddenness but because of what they leave behind: unanswered questions, lingering fears and, for many, a life forever changed.

In South Africa, as in much of the world, stroke rates are climbing, particularly in sub-Saharan Africa, where it’s one of the leading causes of adult mortality. 

But here’s the thing, strokes aren’t just random acts of fate waiting to upend lives. They’re often rooted in preventable risks, and knowing how to spot the signs and act quickly can make all the difference. 

So, let’s break it down, one question at a time.

What is a stroke?

"Think of a stroke as a 'brain attack'," said Dr Hofmeyr Viljoen, a neuroradiologist at SCP Radiology. 

It happens when blood flow to a part of the brain is cut off or reduced, depriving brain cells of the oxygen and nutrients they need to survive.

Within minutes, brain cells begin to die, and the damage can be permanent unless help arrives fast.

There are two main types of strokes:

• Ischemic stroke: A blood clot blocks the flow of blood to the brain. This is the most common type.
• Hemorrhagic stroke: A blood vessel bursts, causing bleeding in the brain. This can lead to swelling and increased pressure in the skull.

Both types are life-threatening emergencies, but they’re treatable if caught in time, stated Dr Viljoen.

How do you spot a stroke?

The key to surviving a stroke is speed. Every second counts, which is why the acronym B.E. F.A.S.T. is your best friend:

• B - Balance: Sudden dizziness or loss of coordination.
• E - Eyes: Blurred or lost vision in one or both eyes.
• F - Face: Drooping on one side of the face.
• A - Arms: Weakness or numbness in one arm.
• S - Speech: Slurred speech or difficulty speaking.
• T - Time: Call emergency services immediately.

Even if symptoms fade quickly, don’t ignore them. This could be a Transient Ischemic Attack (TIA), also known as a “mini-stroke", which is often a warning sign of a major stroke.

Are strokes only for the elderly?

It’s a myth that strokes only target older adults. While age is a significant risk factor, especially for those over 55, strokes can happen at any age.

In fact, younger people are increasingly affected, often due to underlying health conditions or lifestyle factors.

Below, Dr Viljoen shares some unexpected causes of strokes in younger adults: 

• Blood clots: These may travel to the brain from the heart or other parts of the body.
• Artery tears: Even a minor neck injury can cause a tear in a blood vessel, leading to a stroke.
• Blood disorders: Genetic conditions that increase clotting risks.
• Infections: Diseases like HIV and tuberculosis can inflame blood vessels.
• Drug use: Cocaine and methamphetamines are known to trigger strokes in younger people.
• Pregnancy, oral contraceptives, and even cancer can also increase stroke risk in younger populations.

What can you do to reduce your risk?

Up to 80% of strokes are preventable. It starts with taking control of your health and knowing your numbers:

• Monitor blood pressure: Hypertension is the leading cause of strokes.
• Manage infections: Get tested for HIV and TB, and adhere to treatment protocols if diagnosed.
• Quit smoking: Tobacco damages blood vessels and increases clotting risk.
• Eat well and move more: A balanced diet and regular exercise are your best defences against obesity, diabetes and high cholesterol.
• Limit alcohol and avoid drugs: Stimulants like cocaine are particularly dangerous.

What happens after a stroke?

Recovery from a stroke is a deeply personal journey, and outcomes vary widely. Roughly 10% of stroke survivors recover almost completely. Others may face lasting challenges, such as paralysis, memory loss, speech difficulties, or emotional changes like depression.

The first 3–6 months after a stroke are critical for recovery, but progress can continue for years with the right rehabilitation and support.

Behind every successful stroke recovery is the power of imaging technology. Neuroimaging allows doctors to quickly determine the type of stroke and the best course of action.

Radiologists play a pivotal role in stroke care, ensuring patients get the right treatment, whether it’s a clot-busting drug or surgery.

Strokes don’t discriminate. They’re not just an “old person’s disease,” and they can strike when you least expect it.