In my work, not once i encounter old people with deterioration and i am having hard time deciding if does symptoms may be related to CVA or not and if a neurologist should be called.

I will explain by a story from the ER: take a 70 year old women who was ok in her functioning, namely need help and diapers but communicate properly and from today there is a deterioration and she is much less communicating.

In her background - recurrent UTIs (and of course UTI may explain the deterioration) but the daughter says her UTIs are not presenting that way. also, she stopped her Xarelto because of Hematuria. Of course this is an alert that CVA is more likely.

But still - i ask for tips in identifying CVAs, not just in the usual weakness in one side of the body.

Thank you

  • 3
    What is your work? In other words, what level of medical training do you have? I think that would affect the answer.
    – Carey Gregory
    Aug 19, 2019 at 17:03

1 Answer 1


Apart from typical paralysis and numbness, symptoms of a transient ischemic attack (TIA) or full blown stroke may include:

  • Slurred speech or hard time understanding speech
  • Dizziness or loss of balance or coordination
  • Sudden severe headache: According to Current Pain and Headache Reports, 2014: "Hemorrhagic strokes, more frequently than ischemic strokes, present with distinct headaches, usually accompanied by focal neurological symptoms" (also see Mayfield Clinic); According to MedLink: "Headache often accompanies acute ischemic stroke. Observational studies indicate that 15% to 40% of patients with acute ischemic stroke report headache in close temporal relation to the event."
  • Impaired vision

Sources: Mayo Clinic, WebMD, American Stroke Association

  • 2
    Hemorrhagic stroke could cause subarachnoid hemmorhage and this headache. I added a link in my answer. I'm not sure about exact mechanism of headache.
    – Jan
    Aug 19, 2019 at 16:59
  • 2
    No, hemorrhagic stroke causes subarachnoid hemmorhage.
    – Jan
    Aug 19, 2019 at 17:03
  • 1
    I'm down voting this answer because it's textbook, and doesn't really relate to the OP's concerns. They stipulated "i ask for tips in identifying CVAs, not just in the usual weakness in one side of the body." Clearly they are asking for subtle signs of stroke, not signs that would alarm everybody. Aug 19, 2019 at 17:15
  • 3
    @anongoodnurse, the OP asks if there are any other symptoms, such as confusion, that can raise suspicion for a stroke. I provided the evidence that they are.
    – Jan
    Aug 19, 2019 at 17:20
  • 2
    Just explaining my DV, not trying to make you explain your answer. Aug 19, 2019 at 17:22

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