Waimei Tai, MD

Mochari-Greenberger H, Towfighi A, and Mosca L. National Women’s Knowledge of Stroke Warning Signs, Overall and by Race/Ethnic Group. Stroke. 2014

Mochari-Greenberger et al. reviewed data from a 2012 American Heart Association commissioned telephone study to evaluate knowledge of stroke warning symptoms in women > 25 years of age. A survey of 1,205 English speaking women revealed that their knowledge about stroke symptoms were low. 51% knew that sudden weakness or numbness on one side of the body or face was a stroke warning sign. But, less than 20% knew that loss of vision or unexplained dizziness may be a stroke symptom. Fortunately, 84% of them knew to call 911 if they thought they were having a stroke. 

There were no significant differences by racial/ethnic group (black, White, Hispanic, or other), but this was likely limited to a survey of English speaking participants only. The survey was also conducted via open ended questions (similar to previously performed surveys sponsored by the AHA) which may require a higher level of knowledge awareness than passive recognition.
What is more heartening is that 4 out of 5 women knew to call the ambulance when they thought they were having a stroke. Of course, if they happen to have unilateral numbness or weakness, of which 50% of them would recognize it being a stroke, it means that only 4 out of 10 women would be able to connect the dots to that “I’m having one sided weakness, I must be having a stroke and therefore, call 911” moment.

This recent survey suggests some modest advancement in stroke symptom knowledge and activation to call for help, but a lot of education still needs to take place.

I think a few targeted messages make the most sense:

1. Warn patients who are previously identified to be at high risk for stroke (via clinical risk factors) and educate them about stroke warning signs, the need for emergent 911 activation and opportunity for treatment with alteplase/other acute treatments if they react and call for help in time
2. Educate not only patients but also their family members and caregivers because frequently the patients may not be aware they are experiencing symptoms of stroke (anytime you interface with the patient or their loved one is an opportunity for stroke education!)
3. Reach out to influential members of the community, educate them about stroke symptoms and have them spread the word (I had one stroke survivor who was actively involved in church, so, volunteer to take brochures and preach gospel and stroke symptoms to their congregation!)