Atypical CVA complaints

"My stroke was not recognized"

It is very important that a stroke is recognized quickly and the emergency telephone number is called immediately.

Women often show atypical symptoms, such as disorientation, confusion and/or loss of consciousness.

The FAST test (Face-Arm-Speech-Time) or the

PLAT test (Praten(talking)-Laughing-Arm-Tongue) is used as a guide to call the emergency telephone.

NOTE! Many people have OTHER complaints or just one complaint!

P : Praten (talk): Have the person say a simple sentence
L : Laughter: Ask the victim to laugh
A: Arms raised: Have the person raise both arms at the same time
T: Tongue: ask to stick out the tongue, can the person do this? Or is the tongue crooked?

What to do if you have other complaints?

What if this test is not sufficient? What if the doctor thinks you are too young for these complaints? CALL THE EMERGENCY TELEPHONE NUMBER!

Not everyone has the same pattern of complaints. Women often exhibit atypical symptoms, such as disorientation, confusion and/or
loss of consciousness. If in doubt, be on the safe side and call the emergency telephone number!

Some complaints are isolated and were the only complaint mentioned!

Frequently mentioned complaints are:

Sudden weakness or paralysis in the arm, leg, or on one side of the body; in arm or leg. Sleeping leg. Not being able to steer your arm properly, as if your arm has a life of its own. Can't write anymore.
Numbness on one side of the body.
Drooping half of face; one corner of the mouth, one eye.
Poor vision. Loss of vision, shrinking field of vision. Dark spot in the corner of the eye. Sudden loss of vision in one eye, drooping eye or double vision. Rolling eyes.
Decrease in strength or coordination.
Dizziness. Vertigo, often accompanied by nausea, vomiting, fever, hiccups or difficulty swallowing. Balance disorders.
Very bad headache. Stabbing headache. Migraine. The sudden onset of a very severe headache. In the worst case, this is accompanied by loss of consciousness. Sometimes there is a feeling as if pins are stuck in the head.
Slurred speech. Language problems, speaking more slowly or with difficulty or being unable to speak
Being disoriented, appearing confused
Decreased consciousness, loss of consciousness
Sudden sleepiness including wanting to sleep a lot
Difficulty understanding spoken language
Numbness on one side of the body, not being fully in the here and now
Nausea and vomiting
Difficulty swallowing or coughing
Just a fall, falling over
Some people behave as if they are drunk
Emotional lability
Difficulty breathing
Just feeling a 'snap' in the head and knowing that something is going on
It has happened that people have been sent home with a burnout diagnosis.
It turned out to be a stroke (CVA).
Not being able to think
Not being able to read
Feeling bad

For all symptoms see the page on stroke.

We know that in particular a lacunar infarction
(1-15 mm small lacunae/infarctions) is poorly recognized.
Read the experience stories on the lacunar stroke page.

Below we describe missed CVAs in true experience stories.

1. Experience story - a thalamic infarction with only drowsiness as the first symptom

My husband suffered a cerebral infarction with mainly atypical complaints. Oral-speech-arm features were missing. His symptoms were that he wanted to take a lot of naps during the day
and during the course of the day an "experience story" emerged in which he said that he had been so busy at work that day. Completely understandable, no other symptoms.
Because I thought it was stress related and didn't trust it, I called the doctor who wanted to see him. Then things went fast.
During the ride to the doctor, he was able to name fewer and fewer things. An hour later in the emergency department, an infarction in the left thalamus was diagnosed. The neurologist found it remarkable that I had not trusted it.

2. Experience story - a ruptured aneurysm

Almost all complaints were dismissed as stress by the GP and the first neurologist, whom I could only see after 6 weeks. Turned out later

to be a ruptured aneurysm.

An admission to hospital followed to clip the aneurysm via surgery through the skull.

Tried to work in adapted work and fewer hours. I suffered severe depression because I pushed my boundaries every day. It turns out that the emotional area is affected. Now, almost 5 years later, I still have a feeling of pressure in my head. It's as if a fist is pressing on it. Fatigue, renewed depression, etc. All this is dismissed as lazy by the UWV doctor. I'm so tired of always fighting the bureaucracy.

There is nothing visible on the outside, so nothing is wrong with you,

is the gist: "Pill and therapy and you can work again."

Clarification by Hersenletsel-uitleg:

An aneurysm is a dilation in an artery or vein due to a weak spot in the vessel wall. This weak spot can tear open and cause bleeding. This is a life-threatening situation. By placing a kind of clamp ('clip') on the aneurysm from the outside through a hatch in the skull roof, the aneurysm is pinched closed (clipping).

3. Experience story - a 29 old man with a stroke

My 29 year old husband had all the symptoms.

We as a family asked te doctor: "Can't it be a stroke?". No, according to the doctor, he should take a paracetamol and go to bed. The next day he was unable to walk and was rushed to hospital by ambulance. "Yes, sorry sir, it was a cerebral infarction, unfortunately you were unlucky. In the future we will not act differently with young people, because the chance is very small."

We still regret that we did not take action against the hospital. My husband mainly suffers from pain in his head as residual symptoms, he gets tired quickly due to overstimulation and therefore when he goes over his limit he has a kind of epileptic seizure in which he faints. Pain in his leg causing him to walk with the help of a stick. And character change; a lot of worrying, no boundaries anymore, so he tends to go on and on about a subject.

4. Experience story - a thalamic infarction

I had none of the known symptoms of a stroke. My right arm tingled when I touched it. When my arm was at rest, I couldn't feel it. This also applied to my right side with the exception of my legs. I was on holiday in France. We only went to the campsite reception a day later because I felt bad. Then it turned out that my blood pressure was above 220...resulting in admission. The CT scan was normal, but days later the MRI scan showed an infarction. It wasn't that people didn't recognize it...I didn't recognize it myself. It turned out that I had a thalamic infarction.

In summary:

tingling in right arm when touched
no feeling in the arm at rest
legs showed no complaints
I didn't feel the right side
high bloodpressure

5. Experience story - five strokes

I felt very strange in my head and went to the GP who referred me to the internist. I could go there a week later. The wednesday before the appointment I felt dizzy, wobbly eyes, I fainted.

The GP came immediately and said: "It must be your balance organ." A few hours later I was in the emergency room, where they also came to the same conclusion. It is my balance organ. Blood pressure was fine and cholesterol was fine. I could go home again. My daughter insisted that we look further.
Finally a doctor said: "tomorrow we will do an MRI scan". The next day I had all kinds of restrictions. I had an MRI scan. It turned out that a vein in the brain stem was torn and a vein in my neck was torn (see vessel wall problems/dissection).
I had had five strokes the day before. Suddenly I was a ticking time bomb.
Now it's been four years and I still have to deal with all kinds of limitations. This is annoying, but they are all human and yes, I am also one of the misdiagnosed. So that's just bad luck.

In summary:

strange feeling in my head
dizzy
wiggling eyes
pass out

6. Experience story - an aneurysm

I had weird headaches. When I lay down I had no pain. When I stood up I felt as if an atomic bomb had exploded in my head.
When I lay down the pain was gone again.
Other than that I had no complaints whatsoever. I was clear and approachable. Fortunately, my doctor trusted her uncanny feeling. It turned out that I had an aneurysm at the age of 48.

Clarification by hersenletsel-uitleg:
An aneurysm is a dilation in an artery or vein due to a weak spot in the vessel wall. This weak spot can tear open and cause bleeding. This is a life-threatening situation.

7. Experience story - SAH

I felt something snap in my head
nauseous, vomiting
double vision
pain in my neck, worst headache ever....

A brain hemorrhage was not immediately suspected. It turned out to be a subarachnoid hemorrhage (SAH).

8. Experience story - cause unknown

On Friday I wrote a message to someone in words, and the person I wrote it to immediately knew: this is wrong.

So immediately to the doctor. I don't know much from there. Except for the wait in the hospital and the fact that my speech became increasingly worse. And my left leg was dragging. So hospital admission. On Tuesday I was allowed to try walking with a walker. MRI scan the next day. There was nothing to see. So I was allowed to go home with a walker and having difficulty speaking. Speech therapy and physio.

In June I went to a concert of "big with a soft G". What a misery that was. Couldn't listen to the songs anymore! Way to busy.

Why can't I handle crowds?

Or stop reading books. No more music. No 3 days of work.

Always tired.

Meanwhile, I'm still wondering what it was in my head?

9. Experience story - thalamus hemorrhage

On holiday in Luxembourg I suddenly felt a terrible pain at the back of my head, as if knives were being stabbed into it.
I wanted to get up from the terrace, but I couldn't, no strength in both legs. Speech was a bit difficult. With the ambulance to the hospital to the Emergency Room on an intravenous drip with fluids, because I was labeled as the tourist; a lot of time in the sun, not enough to drink, so it must be sunstroke.
Because of the fluid I received I had to go to the toilet but I still had no strength in my legs.
In the wheelchair then.... but still no alarm bells from the nurse.
I was put on an intravenous drip and it was very busy in the ER.
I didn't get better... finally 2 hours later an MRI was done.
The neurologist came, some tests were done and it turned out... it was a hemorrhage in the thalamus.
I had to go straight to the Intensive Care Unit..... what a sudden panic.
I suffer a lot from the invisible consequences. I get tired very quickly and I suffer from a lot of stimuli in my head
etc etc. I have to rest in the afternoon to recharge the battery.

In summary:

severe pain at the back of the head - stab feeling
no strength in the legs
speech a bit difficult

10. Experience story - TIA

Almost two and a half years ago after a short period

symptoms of loss (drooping corner of mouth, loss of strength in right arm and confused speech) was taken to hospital. Returned home a few hours later with much too high blood pressure.

The GP had to regulate the blood pressure with medication. When I got home I turned out not to be feeling well and more than a month later an MRI showed that no recent infarction had occurred, but there were white matter abnormalities due to insufficient blood flow.

The neurologist found nothing wrong....referred to other specialists, the last of whom saw me because of the persistent

cognitive complaints and fatigue were sent to another neurologist. This came six months after the symptoms of the failure with a diagnosis: a TIA in the left hemisphere

with risk factor hypertension (high blood pressure). I received cognitive rehabilitation and an NPO revealed cognitive disorders.

Mental fatigue and overstimulation, among other things, are things I still struggle with every day.

So I have residual symptoms from a TIA, I read/hear few others about this and I wonder if there are more people with a similar experience.

11. Experience story - SAH

Out of nowhere I got a huge headache when I lay down. When I sat down again the pain shot up between my shoulder blades. Other than that I could do everything and there was nothing wrong with me.

I called the doctor's office and suddenly had to throw up.

As a result, an ambulance arrived. At the emergency room they did all kinds of tests that only showed some increased muscle tension.

The neurologist walked away with a shrug but was back within five minutes with the results of the scan.

It turned out that I had a SAH and the most favorable form of it. A perimecencephalic hemorrhage. That is a bleeding between the meninges. There is a good chance that if I had gone to the GP or the GP post, I would have been sent away because there was nothing else to be found wrong with me.

In summary:

huge headache when lying down
pain up to the shoulder blades when sitting
vomiting
increased muscle tension