CEREBRAL VASCULAR ATTACK

A stroke (cerebrovascular accident) occurs when blood flow to an area of the brain stops or a blood vessel in the brain ruptures. It is a medical emergency: at the first signs, call 112 immediately. After stabilization, personalized neurological rehabilitation helps restore walking, arm use, speech, and independence.

What you need to know about stroke:

• Symptoms appear suddenly and usually affect only one side of the body.
• The BE-FAST test helps you quickly recognize a stroke and call 112.
• Hospital treatment depends on the type of stroke and the time of onset.
• Rehabilitation begins after medical stabilization, with the approval of the treating team.
• The greatest progress usually occurs in the first months, but improvements can continue afterward.

What are the symptoms of a stroke?

Stroke symptoms appear suddenly and depend on the area of the brain affected. The most common are:

• facial asymmetry, with one corner of the mouth drooping;
• sudden weakness or numbness in an arm or leg, usually on one side of the body;
• slurred speech, difficulty finding words or understanding a simple request;
• sudden loss of vision in one eye or double vision;
• loss of balance, dizziness, unsteady walking or lack of coordination;
• a very severe headache that appears suddenly, sometimes accompanied by nausea and vomiting;
• confusion, drowsiness or difficulty swallowing.

Aphasia affects the understanding or expression of language. Dysarthria means that the person knows what they want to say but can no longer articulate the words correctly.

Emergency signs: how do you recognize a stroke with the BE-FAST test?

The BE-FAST test checks, within seconds, the most common signs of a stroke. If you notice even one of them, call 112 immediately, even if the symptoms seem to improve.

The test is not enough to establish a diagnosis and does not rule out every form of stroke, but it encourages a rapid response. Symptoms that disappear within a few minutes may indicate a transient ischemic attack (TIA), which also requires emergency evaluation.

What do you do until the ambulance arrives?

Call 112, tell the dispatcher that you suspect a stroke, and give the time of onset or the last time the person had no symptoms. Mention, if applicable, any anticoagulant treatment, diabetes, recent injuries, and a history of stroke.

Until the crew arrives:

• place the person in a safe spot and do not let them walk without support;
• loosen tight clothing and monitor their breathing;
• place the person in the recovery position if they have lost consciousness but are breathing normally;
• follow the dispatcher's instructions if breathing stops or becomes abnormal;
• prepare the list of medications and any available medical documents.

Do not give water, food or medication. A stroke can affect swallowing. Do not drive the person to the hospital if an ambulance can reach them.

What types of stroke are there and what are the causes?

There are two main types of stroke: ischemic, caused by a clot that blocks an artery, and hemorrhagic, caused by the rupture of a blood vessel. Ischemic stroke is the most common form.

• Ischemic stroke: the clot can form directly in the vessel or can originate in the heart, for example in atrial fibrillation. Atherosclerosis and arterial dissection are other possible causes.
• Hemorrhagic stroke: uncontrolled hypertension, aneurysms, vascular malformations and certain anticoagulant treatments increase the risk.
• Transient ischemic attack: causes similar symptoms that disappear completely, but increases the risk of a stroke in the following period.

Stroke occurs more often after the age of 55, but it can also affect young adults, including active people and athletes.

How is stroke diagnosed and treated in the hospital?

The diagnosis is made through a neurological examination and imaging. Computed tomography quickly distinguishes a hemorrhage from an ischemic lesion, while CT angiography and MRI provide additional information about the arteries and the lesion.

In ischemic stroke, doctors may recommend intravenous thrombolysis, which dissolves the clot, or mechanical thrombectomy, in which the clot is removed with a catheter. Eligibility depends on the time of onset, the imaging, and the patient's condition.

In hemorrhagic stroke, the team controls blood pressure, may reverse the effect of anticoagulants and, in some cases, recommends surgical or endovascular intervention. Every procedure carries risks, which doctors weigh against the estimated benefits.

When does rehabilitation begin after a stroke?

Rehabilitation after a stroke begins after medical stabilization, usually while still in the hospital, with the approval of the treating team. Very intensive mobilization in the first 24 hours is not recommended, because it has not shown benefits compared with usual care.

Early intervention, adapted to the patient's condition, can prevent contractures, muscle loss and the complications of immobilization. Neurological rehabilitation then continues on an outpatient basis or at home, depending on each patient's needs.

What are the stages of stroke rehabilitation?

Stroke rehabilitation usually takes place in three stages: acute, in the hospital; subacute, in the first months, when progress is usually fastest; and chronic, in which the program consolidates results and aims for long-term independence.

The pace differs from one person to another. Improvements can continue after the first months if the program is adjusted periodically.

What does a stroke rehabilitation protocol include?

A stroke rehabilitation protocol begins with an assessment of motor function, balance, walking, communication, swallowing and independence. Based on the results, the team sets measurable goals adapted to everyday life.

The rehabilitation medicine specialist may recommend:

• physical therapy for posture, transfers, walking, balance and use of the affected arm, through repeated exercises focused on concrete tasks;
• occupational therapy for dressing, hygiene, eating and other daily activities;
• speech therapy for aphasia, dysarthria and swallowing disorders;
• cognitive exercises for memory, attention and planning;
• functional electrical stimulation or biofeedback, if the specialist considers them appropriate;
• psychological support for the patient and the family.

Neuroplasticity describes the brain's ability to reorganize its connections through repeated exercise. Physical therapy sessions make use of this mechanism, and the intensity increases gradually, depending on tolerance and progress.

What after-effects can remain after a stroke and how are they addressed?

Common after-effects include weakness on one half of the body, spasticity, and problems with balance, speech, swallowing and memory. Each of these has a specific therapeutic approach, established by the medical team after an assessment.

A complete recovery cannot be guaranteed, and the outcome depends on the location of the lesion, how quickly treatment was given, and consistency in therapy.

How can the family support recovery at home?

The family can adapt the home: they can remove rugs that make walking difficult, install grab bars and ensure good lighting. Encourage the patient's independence, but respect the limits set by the therapist.

Do not pull the patient by the affected arm and do not introduce exercises taken from non-specialist sources. Seek medical help if new neurological symptoms, fever, repeated falls, swelling of a limb, episodes of choking during meals or persistent emotional changes appear.

How do you reduce the risk of another stroke?

The risk of another stroke decreases by controlling blood pressure, blood sugar and cholesterol, quitting smoking, limiting alcohol and doing adapted physical activity. After a stroke, the doctor determines secondary prevention depending on the cause.

Do not stop anticoagulant, antiplatelet or antihypertensive treatment without the doctor's approval. Adopt a diet rich in vegetables, fruit, legumes, whole grains and fish, and reduce your intake of salt and ultra-processed foods.

How does the Centrokinetic team help you with stroke rehabilitation?

At Centrokinetic, neurologists, rehabilitation doctors, physical therapists and speech therapists work together on a personalized rehabilitation plan. The program can include individual therapy, gait retraining, upper limb recovery and recommendations for home.

The benefits of a proper assessment: it identifies the patient's real needs, sets measurable functional goals and allows the program to be adjusted as progress is made.

If new symptoms appear, call 112. After medical stabilization, you can request a neurology consultation for an assessment and an adapted rehabilitation plan.

Frequently asked questions about stroke

What are the three main signs of a stroke?

Facial asymmetry, weakness in one arm and a sudden change in speech. The presence of even one sign requires an immediate call to 112.

What should I do if the symptoms disappear quickly?

Call 112 even if the person seems to have recovered. Temporary symptoms may indicate a transient ischemic attack, which requires urgent evaluation.

When does physical therapy begin after a stroke?

Physical therapy begins after the patient is stabilized, with the approval of the medical team. The specialist adapts the intensity to the neurological condition, exercise tolerance and associated conditions.

How long does stroke recovery take?

The duration varies from a few weeks to months or years. The greatest progress usually occurs in the first months, but improvements can continue afterward, with an adapted program.

Is a complete recovery possible?

Some people regain their independence, while others are left with certain limitations. The outcome depends on the location of the lesion, how quickly treatment was given, associated diseases and consistency in therapy.

Disclaimer: The information presented is for informational purposes and does not replace a specialist medical consultation.

Sources:

• AVERT Trial Collaboration Group. "Efficacy and Safety of Very Early Mobilisation within 24 h of Stroke Onset (AVERT): A Randomised Controlled Trial." The Lancet, vol. 386, no. 9988, 2015, pp. 46-55, doi:10.1016/S0140-6736(15)60690-0. Accessed on 17 Oct. 2026.
• "Recovering from a Stroke." NHS, 12 Sept. 2024, [www.nhs.uk/conditions/stroke/recovery](https://www.nhs.uk/conditions/stroke/recovery). Accessed on 17 Oct. 2026.