What are the early warning signs of a stroke?

A stroke requires immediate hospital care, but most Americans don't recognize the symptoms of this potentially deadly "brain attack." This widespread lack of awareness often results in long-term disabilities that could have been prevented.

A 2008 survey conducted by the Centers for Disease Control and Prevention in 13 states and the District of Columbia revealed that most people can't identify the five most common symptoms of stroke, which include sudden confusion or trouble speaking; numbness, weakness or paralysis of the face or appendages, especially on one side; sudden vision impairment; dizziness and loss of balance; and severe headache.

Less than 44 percent of respondents in the survey correctly identified all five stroke symptoms, though awareness of individual symptoms ranged from 60.4 percent for severe headache to 92.6 percent for numbness or weakness.

These findings are concerning because prompt treatment is necessary to save brain tissue after a stroke occurs. With each passing minute, 2 million brain cells die, increasing the risk of permanent brain damage, disability and death.

When the cells die, abilities controlled by that area of the brain, such as speech, movement or memory, are impaired or lost. In the U.S., stroke is leading cause of adult disability and the third leading cause of death, killing 160,000 people each year, according to the National Stroke Association, Centennial, Co.

Strokes cut off blood and oxygen flow to the brain, and the brain does not tolerate long periods of oxygen deprivation," says Dr. Shalini Bansil, medical director, Overlook Hospital stroke center, Summit, N.J.

Stroke does not afflict just the elderly. Healthy, active individuals in their 20s and 30s suffer strokes, as well, Bansil says.

For the best possible outcome following a stroke, a clot-dissolving medication called tissue plasminogen activator, or tPA, must be administered within three hours of the onset of symptoms.

It's kind of like Drano for the brain - it takes away the clog," says Diane Mulligan, vice president of communications for the National Stroke Association.

Beyond that three-hour window, only hospitals with comprehensive stroke centers can provide advanced interventional procedures, such as mechanically removing the clot causing the stroke, to stall or reverse damage to the brain. (Visit www.stroke.org to locate your nearest stroke center.)

Someone who is wheeled in unable to walk, speak or see has a shot, with prompt, appropriate treatment, to literally walk out of the hospital within two days with no disabilities," Mulligan says. "Unfortunately, it takes the average American 12 to 24 hours to get to the hospital, which is a disaster."