8 Weird Signs You’re Having a Stroke

Stroke symptoms “can vary greatly depending on where in the brain the injury happens,” says Matthew Gusler, DO, an assistant professor of neurology at the Ohio State University Wexner Medical Center in Columbus.

That said, it can be tricky to determine whether those symptoms are from a stroke or a minor complaint. Here, time is of the essence, since immediate treatment can reduce the risk of brain damage and long-term disability — and could even save your life.

Sudden, Severe Vertigo

When you’re in the throes of vertigo, you may feel extremely dizzy, as if the room is spinning. “I’ve had patients describe this to me as ‘I could not keep the room or the world around me still’ or ‘I just could not keep my balance and kept tilting to a side,’” says David Rhee, MD, a cardiologist with Manhattan Cardiology in New York City.

“If you notice sudden-onset vertigo, this can be concerning, especially if you have other symptoms such as double vision or clumsiness on either the right or left arm and leg,” he says.

Thunderclap Headache

“My patients have almost all described this as a sudden onset of the absolute worst headache of their life,” Dr. Rhee said. “It’s usually debilitating and unlike any they’ve ever had before.”

Rhee says some people attribute the headache to a particularly bad migraine, but he urges everyone not to dismiss it, especially if it’s accompanied by other symptoms like nausea, vomiting, numbness, and a stiff neck.

Not every intense headache is a symptom of a stroke, but in this case, it requires emergency care by a doctor who can rule it out, says Alexis Simpkins, MD, PhD, the director of stroke research in the department of neurology at Cedars-Sinai Medical Center in Los Angeles.

Vision Changes

Sudden vision changes in one or both eyes — such as double or blurry vision — are an often-missed symptom of a stroke, says Rhee.

Unexplained Nausea and Vomiting

Nausea and vomiting can be caused by any number of conditions, from a stomach bug to acid reflux. But there are a few signs that they might be due to a stroke.

With a stroke, “the nausea and vomiting are sudden, severe, and unrelenting,” says Rhee. They appear “without cramping, lower abdominal pain, or diarrhea — and without a clear trigger.” (Other tells: You’ve had no recent exposure to suspicious foods and no one else who ate with you is sick.)

Typically, if nausea and vomiting are from stroke, there will also be other neurological symptoms such as weakness, incoordination, vertigo, or double vision, Gusler says.

Hiccups

“Not all hiccups need the emergency room,” Rhee says. “But if they’re persistent, I would make sure there are no issues with balance, nausea, dizziness, or trouble swallowing, which are [also] associated symptoms of Wallenberg syndrome.”

Sudden Confusion

“The key is the sudden onset where someone is totally normal one minute and then very confused a minute later,” Gusler says. “While many things can cause confusion, such as infection or reaction to a medication, not many cause confusion that suddenly.”

Clumsiness or Dropping Things

Arm weakness is one of the most common and well-known signs of stroke, but it may not always present in an obvious way, Rhee says.

“A large stroke may cause clear weakness in an arm, but a smaller stroke in a specific part of the brain can cause trouble with coordinated movements, even if the strength is normal,” he explains. For example, “people might fumble with their buttons or bump into things and change the way they walk.”

It’s especially concerning for a stroke if a bout of clumsiness happens all of a sudden, especially if it only impacts one side of the body, Gusler says.

Who Is at Risk for Atypical Symptoms?

While anyone can experience these lesser-known signs of stroke, research suggests women are more likely to experience atypical symptoms.

People with vertebral artery dissection may develop nausea, imbalance, headache, and vision changes, says Rhee. Pain that appears on one side of the neck is another sign of a dissection.

What to Do if Something Feels Off

If you think you might be experiencing a stroke, seek emergency medical care immediately. “The hallmark characteristic of a stroke is the sudden onset of symptoms,” says Gusler. If this happens, call 911 and go straight to the hospital.

Emergency treatments for stroke are extremely time-sensitive. “Treatment that’s given an hour after symptoms start is much more effective than treatment given four hours after symptoms start,” Gusler says. “If you wait, we could miss the window for effective emergency treatment.”

Dr. Simpkins adds that going to the hospital will also allow medical providers to ensure that the symptoms are not from another condition that can mimic stroke but may require different treatments.

Finally, Rhee says that even if you can’t speak, you should still dial 911. “Just mumble or hit the table,” he says. “They are trained to assume it’s an emergency and will send help to your location.”

If someone you know may be vulnerable, frail, or lives alone, he advises taking a moment to teach them how to activate SOS on their cellphone. “Most cellphones automatically call 911 after a countdown if you press the power button quickly five times,” Rhee says.