The time between the onset of a cerebral infarction and the start of treatment directly determines the severity of long-term disability and life expectancy. The most crucial thing upon onset is to know the four easily recognizable signs (FAST)and call 119/911 without hesitation.
Even if symptoms disappear in a few minutes, it could be a Transient Ischemic Attack (TIA), which is a highly likely precursor to a major stroke. The decision to “wait and see” can lead to irreversible consequences.
Main Symptoms of Cerebral Infarction – Check Immediately with FAST!
| Item | Meaning | Specific Symptoms (Points Not to Miss) | How to Check |
| Face | Face | One side of the mouth droops. Smile is clearly asymmetrical. | Ask the person to “Smile brightly.” → One side does not lift or sags. |
| Arm | Arm | One arm cannot be lifted or immediately drops. Weakness or numbness in one arm. | Ask the person to “Raise both arms 90 degrees forward and hold for 10 seconds.” → One side drifts down or cannot be raised. |
| Speech | Speech | Slurred speech. Words are mumbled or pronounced strangely. Inability to say the intended words. | Ask the person to “Say, ‘The weather is nice today.’” →Speech is slurred, sounding like “Thw wethr iz nys tdy.” |
| Time | Time | Call 119/911 as fast as possible! The time from onset determines the outcome. | If even one symptom is present, call an ambulance immediately. Never “wait and see”! |
Important Symptoms Other Than FAST
| Symptom | Characteristic |
| Sudden, severe headache | “The worst headache I’ve ever experienced” ⟹ Possible subarachnoid hemorrhage too. |
| Dizziness / Balance problems | Especially inability to stand up or walk. |
| Vision loss | Half of the visual field is missing (hemianopsia), or double vision (diplopia). |
| Numbness / Paralysis in both limbs | Caution is needed even if both sides (not just one side) are affected. |
| Clouded consciousness | Slow response to verbal stimuli, appearing sleepy. |
| Difficulty swallowing | Choking on water, drooling. |
Crucial Key Points
- Symptoms begin suddenly (reaching a peak in seconds to minutes).
- Do not let your guard down even if symptoms are temporary or disappear! → Possible Transient Ischemic Attack (TIA). The probability of a major stroke within 24 hours of TIA is 5−10%.
- In the elderly, the only symptom may be a vague sense of drowsiness/lethargy.
What Family/Bystanders Should Do (3 Steps)
- Perform the FAST check (Can be done in 30 seconds).
- Confirm the time of onset (The last known time the person was normal).
- Call 119/911 immediately → State, “Suspected stroke, FAST positive.”
