F.A.S.T Stroke recognition and response: F. Facial asymmetry: Ask the patient to smile, is one side of the face low hanging? A. Arm weakness: Ask the patient to straighten the arm to both sides, is one side slightly drooping? S. Speech impairment: Ask the patient to repeat a short sentence, can the patient repeat it, or is the speech strange or slurred? T. Seek medical attention as soon as possible: When there are signs of stroke, call 120 emergency as soon as possible. Stroke occurs due to blockage or rupture of some cerebral blood vessels. What are the causes of stroke? Stroke occurs in two ways: blockage of a blood vessel in the brain (interruption of blood flow; called ischemic stroke) or rupture of a blood vessel in the brain (called hemorrhagic stroke). Of these, the former is more common than the latter. Risk factors for stroke include high blood pressure, high blood cholesterol, diabetes, smoking, atrial fibrillation and lack of physical activity. Therefore, maintaining a healthy lifestyle and actively controlling all body parameters can greatly reduce the risk of stroke. What are the signs and symptoms of stroke? When the blood supply to the brain is inadequate, a variety of signs and symptoms can occur, and the form and severity of the symptoms depend on the location of the brain tissue involved. The main signs of stroke are: asymmetry of the face; weakness of one limb (e.g. involvement of the upper or lower limb, or both upper and lower limbs); numbness or abnormal sensation in one limb; slurred speech (slurred pronunciation; inability to repeat a short sentence). What should we do if there are signs of a stroke? If you think you have had a stroke, it is important to seek medical attention as soon as possible. The shorter the time between the onset of the stroke and the start of treatment, the better the chances of recovery. Therefore, if you notice any of the above signs of stroke, seek medical help immediately and never wait until the signs are more obvious. This is because there is a drug that can reach the blockage through the bloodstream and dissolve the clot, and this drug is only effective for the first few hours after the stroke. Once that window of effectiveness is missed, the drug is not only ineffective, but even harmful. Therefore, it is important to accurately document the time of stroke onset and the time of disappearance of signs and symptoms. The JAMA journal (April 23/30, 2014) published an article on reducing the time to visit a stroke patient, which suggested that starting thrombolytic therapy in an ambulance is significantly more effective than treatment upon arrival at the hospital.