Quick Answer
A stroke (cerebrovascular accident) is when blood flow to part of the brain is interrupted — either by a clot (ischemic, 85%) or a burst vessel (hemorrhagic, 15%). Every minute of interrupted blood flow costs 1.9 million neurons (Saver, Stroke 2006). Recognize with FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 1669 (Thailand) or 911.
1. What Happens During a Stroke
Brain cells need constant oxygen. When a clot blocks an artery or a vessel bursts, downstream cells begin to die within 3-4 minutes. Hankey (Lancet 2017) estimates each stroke destroys 1.9 million neurons per minute of untreated blood flow loss.
2. FAST — The Recognition Tool AHA/ASA Recommends
Every family should memorize FAST:
- F — Face: ask them to smile; does one side droop?
- A — Arms: raise both arms; does one drift down?
- S — Speech: repeat a simple sentence; is it slurred?
- T — Time: if ANY sign is positive, call emergency services immediately
3. Two Main Types
Stroke is not one disease:
- Ischemic (85%) — blocked artery from clot or atherosclerosis
- Hemorrhagic (15%) — burst artery, usually from hypertension
- TIA ("mini-stroke") — same symptoms, resolves within 24 hours, but is a warning of imminent major stroke
4. Time is Brain
Saver (Stroke 2006) quantified: for every hour of untreated ischemic stroke, the brain ages 3.6 years. tPA must be given within 4.5 hours; mechanical thrombectomy (EVT) within 24 hours. Fast hospital arrival is the single strongest predictor of good outcome.
5. What Rehabilitation Looks Like
After the acute phase (1-2 weeks in hospital), rehabilitation begins. Winstein (AHA/ASA 2016) recommends multidisciplinary inpatient rehab with:
- PT — walking, balance, strength
- OT — hand function, daily living skills
- SLP — speech and swallowing
- PM&R physician oversight
- Rehab nursing 24 hours
- Sanpiti average: 2.6 months stay, 87% walking before discharge
Frequently Asked Questions
What causes a stroke?
Ischemic strokes come from clots (atherosclerosis, atrial fibrillation). Hemorrhagic strokes come from ruptured vessels (usually chronic hypertension, sometimes aneurysm or AVM).
Is stroke reversible?
The dead brain cells do not return, but surrounding cells can rewire through neuroplasticity. Most patients regain meaningful function with early intensive rehabilitation. Sanpiti sees 87% of non-ambulatory patients walk again before discharge.
How fast should I act if I see FAST symptoms?
Immediately. Call 1669 (Thailand emergency) or 911. Do not drive to hospital — ambulances have priority routing and can alert the stroke team before arrival, saving critical minutes.
What is the difference between stroke and TIA?
TIA symptoms resolve within 24 hours (usually much sooner) because the clot dissolves on its own. But TIA is a serious warning — 10-15% of TIA patients have a full stroke within 90 days. Always evaluate a TIA in the ER.
Rehabilitation After Stroke — Bangkok's Largest Network
Sanpiti operates 9 inpatient rehabilitation branches across Bangkok, purpose-built for stroke recovery. 5,000+ families served over 10+ years.