A stroke often seems to occur without warning. In some situations, though, there may be potential warning signs before a stroke happens, such as a severe headache and a transient ischemic attack (TIA).

A man sits at a table at home looking tired, holding his head in one hand, while a woman next to him consults an electronic tablet. Share on Pinterest
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A stroke happens when blood flow to part of your brain is blocked or interrupted. This prevents the brain cells from getting the oxygen and nutrients needed to survive.

A stroke is a medical emergency that needs immediate treatment. Recognizing the symptoms of a stroke can help you get help as quickly as possible.

Although stroke symptoms seem to happen out of the blue, there may, in some situations, be potential warning signs that shouldn’t be ignored.

It’s not always possible to predict a stroke, but some people may have warning signs that need attention.

A severe or unusual headache

Although this isn’t the case for all strokes, in some situations, a certain kind of headache may be an early indicator of a pending stroke.

According to a 2020 study of 550 adults, a sentinel headache was found to precede an ischemic stroke in 15% of study participants. A sentinel headache is defined as a headache that occurs before an event, defined as 1 week before a stroke in this case.

The authors of the study noted that these headaches were either severe in nature or different from any previous headache.

Additionally, these headaches started within 7 days of a stroke and often lasted until stroke symptoms happened. It was also found that participants who had a sentinel headache before a stroke were more likely to have had atrial fibrillation — a type of arrhythmia — than participants in the control group who didn’t have a stroke.

What is an ischemic stroke?

An ischemic stroke is a type of stroke that’s caused by a blockage, usually due to a blood clot, in one of the blood vessels that supplies the brain. This is the most common type of stroke.

A less common type of stroke is a hemorrhagic stroke. It’s caused by an artery in the brain that leaks or ruptures.

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A sentinel headache is also considered to be a sign of an impending aneurysm rupture. It’s important to take any unusual or severe headache seriously, as it could be a predictor of a more serious health event.

A transient ischemic attack (TIA)

Another possible warning sign of a stroke is a TIA, also known as a “ministroke.” A TIA occurs when the blood supply to part of your brain is interrupted for a short period of time. While the symptoms of a TIA can mimic those of a stroke, the symptoms usually disappear within an hour and rarely cause permanent damage. In some cases, symptoms can persist for up to 24 hours.

Although the symptoms of a TIA usually don’t last long, it’s important to get medical attention, even if the symptoms go away. While a TIA usually resolves quickly, it may be a sign that a more serious stroke could happen down the road. In fact, it’s estimated that about one-third of people who have a TIA will have a more severe stroke in the future.

Interestingly, a recent study confirmed that while having a TIA can be a precursor to a stroke, the number of people experiencing an acute stroke within 90 days of a TIA has decreased in recent years. This could be an indication that preventive measures following a TIA are effective at preventing stroke.

What are the symptoms of a TIA?

Symptoms of a TIA are similar to those of a stroke, but they usually resolve quickly. If you notice any of the following symptoms, get medical attention right away:

  • paralysis or weakness on one side of the body, usually in the face, arms or legs
  • difficulty speaking or understanding
  • loss of balance or coordination, trouble walking
  • trouble seeing in one or both eyes
  • confusion
  • headache
  • dizziness

Getting a medical evaluation within 60 minutes of the start of symptoms can help identify the cause of the TIA. This can help ensure that you get the right type of treatment which may lower your risk of a future stroke.

According to research, up to 80% of strokes after a TIA are preventable, based on timely diagnosis and treatment.

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In the event of an acute stroke, people who are able to get treatment within 3 hours of symptom onset experience better treatment outcomes with fewer long-term issues.

Anyone can have a stroke, but these factors increase your risk:

  • High blood pressure: High blood pressure is a leading cause of stroke and the most significant controllable risk factor.
  • Diabetes: Having either type 1 or type 2 diabetes makes you twice as likely to have a stroke compared with someone without diabetes.
  • High LDL cholesterol: Having high levels of LDL cholesterol, also known as “bad” cholesterol, can cause cholesterol to build up in your arteries.
  • Heart disease: Some types of heart disease, especially atrial fibrillation (AFib), significantly increase your risk of stroke.
  • Smoking: Smoking damages your cardiovascular system and blood vessels, making it easier for blood vessels to rupture or for fatty material (plaque) to accumulate.
  • Sex: Men are more likely to have a stroke earlier in life than women. However, women tend to live longer than men, so have a higher lifetime risk of stroke.
  • Age: Stroke can occur at any age, but your risk increases with age.
  • Race and ethnicity: In the United States, stroke occurs more often in African American, American Indian, Alaska Native, and Hispanic adults than in White adults of the same age.

Language matters

You’ll notice that the language used above to share stats and other data points is pretty binary, especially with the use of “men” and “women.”

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Although you may not be able to completely prevent a stroke, you can take steps to greatly reduce your risk with the following preventive steps:

  • Try to keep your blood pressure within a healthy range.
  • Know your cholesterol levels, and have your cholesterol checked at least every 5 years.
  • Get checked for any heart issues and follow a treatment plan as needed.
  • Monitor and control your blood sugar if you have diabetes.
  • If you smoke, consider quitting.
  • Maintain a moderate weight.
  • Try to exercise all or most days of the week.
  • Eat a diet that limits saturated fats and cholesterol.
  • Take any medications to manage and treat known health conditions.

Stroke symptoms may seem to come on suddenly, but there may be warning signs in some situations. A severe headache, or any unusual type of headache, is one potential warning sign of a stroke.

Having a TIA, or “ministroke,” may also be a precursor to a more serious stroke. While the stroke-like symptoms usually resolve within an hour, it’s still important to get prompt medical attention. By getting a timely diagnosis and treatment, you may be able to lower your risk of a future stroke.