Every minute that passes without treatment leaves brain cells at risk, so as loved ones gather for the holidays, knowing what to look for is crucial.
As an O-R nurse, Erwin Elbis has seen pain every day on the job for 26 years. Recently, he lived that pain.
"It was probably the worst headache I've ever had," said Elbis, a nurse anesthetist at Florida Hospital.
Three days of head-splitting pain.
"As soon as I got up, I just fell to the floor, I could not feel my right side," said Elbis.
Elbis was having a stroke. He managed to drag himself downstairs to his car, and in a daze, drove to the hospital.
Doctors put in a stent in to get the blood flowing to his brain, but then came a dangerous fever.
"His body was 102, 103 degrees, so basically, his brain was cooking," said Florida Hospital critical care physician Dr. Michael Rodricks.
Doctors used a newer procedure for stroke called normothermia. Cooling gel pads are placed on the body to reset the patient's internal thermostat to 98.6 degrees. It saved Erwin's brain and his life.
"Without a doubt, I think advanced fever control and temperature modulation is the wave of the future," said Rodrick.
Still, experts say one of the most important tools in treating stroke is time.
Strokes happen when a brain artery becomes clogged or when blood vessels break and blood flow is lessened.
Without blood flow parts of the brain will begin to die. The sooner someone experiencing a stroke is brought in to a hospital, the better the chance of preventing brain damage.
If a clot is causing the stroke, a medication called TPA can be given within several hours of symptom onset.
"One of the major efforts we are making is in the City of Chicago to have ambulances bring acute stroke patients to hospitals where we know in advance they are set up to evaluate people and give TPA," said Dr. Richard Bernstein, a Northwestern Medicine neurologist.
So how can you tell is someone is having a stroke?
The National Stroke Association has created an easy-to-remember guide called >Act F.A.S.T.
The "F" stands for 'Face'. Ask the person to smile. If they have trouble or their face droops in any way, take note.
The "A" is for 'Arms'. Ask them to raise both arms. Does one arm drift downward?
The "S" stands for 'Speech'. Ask the person to repeat a simple sentence. Are the words slurred?
Finally, "T" is for 'Time'. If a person fails the previous three tests, call 9-1-1 or get to the hospital fast.
"There are a lot of other subtle signs, but I think if people just remember face, arms speech and time, they are going to get about 95 percent of strokes," said Bernstein.
Erwin Elbis knew enough to get to the hospital, and now he is refocusing his priorities.
"The goal now for me is to help others," said Elbis. "Support those people that are surviving and have survived and are struggling themselves to get back on track."
Doctors suspect an irregular heart rhythm called atrial fibrillation may be the cause of a significant amount of strokes.
Northwestern is now enrolling patients who had a stroke of unknown cause in a trial where a device is implanted under the skin to monitor whether the heart's rhythm is off.
National Stroke Association
Northwestern Memorial Hospital