The Claim: A Stroke Can Be Diagnosed in Three Steps

NY Times ^ | May 9, 2006 | ANAHAD O'CONNOR

[neverdem]

Really?

THE FACTS Most people can spot the telltale signs of a heart attack. But a stroke?

Studies show that stroke victims sometimes fail to realize that they have suffered an attack or to seek medical help until crucial hours later. Minor strokes are sometimes dismissed as migraines or fatigue.

So when an e-mail message claiming that anyone can diagnose a stroke in three simple steps surfaced recently, it was tantalizing. It claims that an untrained bystander can tell whether people have suffered a stroke by asking them to smile, raise both arms slowly and recite a simple sentence.

A small study presented at a meeting of the American Stroke Association in 2003 suggested the test.

But because the symptoms of a stroke vary widely, the three-step test can detect some victims but will miss many others, said Dr. Larry Goldstein, the director of the Duke Stroke Center.

Some of the more common symptoms of a stroke, for example, are problems seeing, an unusual headache, sudden numbness and trouble with coordination or walking — all of which the three-step test overlooks.

"The danger is that someone can have abrupt changes in their neurological capabilities that are dismissed because they aren't one of those three things in the test," Dr. Goldstein said.

[neverdem]

If anyone thinks someone has had a stroke there's no time to waste. That person needs a CT scan of the brain as soon as possible to confirm that an ischemic stroke is the correct diagnosis so that the clot-busting drug tissue plasminogen activator(tPA) can be given within three hours of symptom onset.

Independent review reaffirms benefit of clot-buster tPA for stroke