Sudden neurological issues should be treated as stroke, doctor advises

Sudden neurological symptoms should be treated as a potential stroke and prompt emergency medical attention sought, according to Dr. Chiang Kuan-yu, Director of Integrated Medicine at Taipei City Hospital’s Zhongxing Branch.

His advice comes after the reported hospitalization of UMC honorary vice chairman Hsuan Ming-chih for an epidural hematoma, a serious brain bleed requiring urgent surgery. Chiang emphasized that the critical factors determining a patient's prognosis include their consciousness score, the location and volume of the hemorrhage, whether it has spread to the brain ventricles, the presence of brain herniation, and the patient's anticoagulation status.

Chiang reiterated the primary principle: "If you suddenly experience neurological dysfunction, treat it as a stroke and call 119 immediately." For individuals who are conscious but exhibit sudden abnormalities, he recommended the "BE-FAST" mnemonic: Balance (sudden unsteadiness), Eyes (sudden double vision or blurred vision), Face (sudden facial drooping), Arm (sudden weakness in one limb), Speech (slurred speech or nonsensical answers), and Time (note the last known normal time).

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If you suddenly experience neurological dysfunction, treat it as a stroke and call 119 immediately.

If a person is found unresponsive in the morning but is breathing, Chiang advised against feeding them and to place them on their side to maintain an open airway while awaiting emergency services. If there is no normal breathing, CPR should be initiated. He stressed that being found unresponsive in the morning does not mean the stroke occurred at that time; family members should provide the last known time the person was well.

Following initial life-saving treatment, the long-term recovery phase, known as Post-Acute Care (PAC), begins. This integrated rehabilitation stage involves a multidisciplinary team of medical professionals, nurses, physical therapists, occupational therapists, speech therapists, and social workers. Both hemorrhagic and ischemic strokes fall under the umbrella of stroke, with initial treatment focused on saving brain cells and PAC and rehabilitation aiming to restore functional abilities and protect the entire family.

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Balance, Eyes, Face, Arm, Speech, Time.