A stroke does not always leave someone unconscious, paralysed or unable to speak. A person may remain awake, walking and talking while experiencing sudden numbness or weakness, especially on one side of the body.
Other warning signs include difficulty finding words, loss of balance and sudden vision changes.
These symptoms may be mistaken for tiredness or stress. However, even mild symptoms require immediate medical assessment. Delays can limit access to time-sensitive treatment and increase the risk of lasting disability.
According to the Department of Statistics Malaysia (DOSM), stroke recorded without a specific ischaemic or haemorrhagic type accounted for 2.6% of medically certified deaths in 2024. This category ranked as Malaysia’s sixth principal cause of death.
Dr Aaron Lai Kuo Huo, Consultant Emergency Physician at SMC, explains, “Many people expect a stroke to look dramatic, but that is not always the case. When symptoms appear mild, many people choose to wait and see if they improve, but these delays can reduce the opportunity for timely assessment and treatment.”
Symptoms may disappear after a few minutes, potentially indicating a transient ischaemic attack (TIA), commonly known as a “mini-stroke”. This is a warning sign that should never be ignored.
“Even if symptoms improve, urgent medical assessment is still needed,” Dr Aaron adds.
Recognise the Signs and Act Quickly
BE FAST helps identify possible stroke symptoms:
- Balance: Sudden loss of balance or coordination.
- Eyes: Sudden vision changes.
- Face: Facial drooping.
- Arms: Weakness or numbness in an arm.
- Speech: Difficulty speaking or understanding speech.
- Time: Seek emergency help immediately.
Dr Aaron stresses that a person does not need to experience every symptom before seeking help.
“Someone experiencing a stroke may still be able to walk or talk, which is why the condition is sometimes overlooked. If stroke is suspected, families should call for an ambulance and try not to drive them to the hospital yourself where possible. In an ambulance, emergency medical personnel can begin monitoring the patient on the way and alert the hospital to prepare for urgent treatment,” he explains.
While waiting, families should keep the person safe and comfortable, follow the dispatcher’s instructions, and avoid giving food, drinks or medication unless advised by healthcare professionals.
They should also note when symptoms began or when the person was last known to be well, as this information can influence treatment decisions.
Recovery Continues Beyond Hospital Discharge
Dr Lim Swee San, Consultant Neurosurgeon & Spine Specialist at SMC, highlights the challenges stroke survivors may face after leaving hospital.
“Families often judge recovery based on whether someone can walk again. However, stroke can also affect speech, memory, concentration and emotional wellbeing. These difficulties may not always be visible, but they can have a major impact on daily life, work and independence.”
Rehabilitation is essential to stroke care. Assessment and planning should begin early, with therapy introduced when the treating team considers it medically safe and appropriate.
Recovery also depends on the location of the brain injury, not just the stroke’s size. Even a smaller stroke affecting an area responsible for an important function can have a significant impact.
“Recovery is different for every survivor. Two people with a similar stroke may recover very differently. The challenges they face, the rehabilitation they require, and the time needed to recover can vary considerably from person to person,” says Dr Lim.
Some survivors may aim to walk independently, while others focus on improving speech, returning to work or resuming daily activities.
“Success should not be measured by comparing one survivor’s recovery with another’s,” explains Dr Lim. “Progress is best considered against the individual’s own goals and the level of independence they are able to achieve safely and meaningfully in their daily life.”
Recovery also involves preventing another stroke. Dr Lim emphasises that survivors remain at risk, even after regaining lost functions.
“Having a stroke once does not mean it cannot happen again. A person who has recovered from a stroke may still be at risk of another stroke in the future. This is why follow-up care, taking medications as prescribed and managing risk factors such as high blood pressure, diabetes, high cholesterol and smoking remain important, even after leaving the hospital,” he says.
A Reminder for Every Family
For Dr Aaron and Dr Lim, stroke requires urgent action when symptoms appear and patience throughout recovery.
Early recognition can help patients access timely treatment, while continued follow-up care and rehabilitation support their journey towards greater safety, independence and a meaningful return to daily life.