Quick answer
The main signs of a stroke are sudden loss of balance, changes in vision, a drooping face, weakness in one arm and slurred speech. An easy way to remember them is BE FAST. If you notice even one of these signs, call for an ambulance straight away on 082 911 (or 112 from a cellphone), note the time the symptoms started, and don’t wait to see if they pass.
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Think it’s a stroke? Call now
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| Key takeaways |
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| •A stroke is a medical emergency. Call an ambulance at the first sign, even if the symptoms fade. |
| •Remember BE FAST: Balance, Eyes, Face, Arms, Speech, Time. |
| •Women and people having a mini-stroke may show signs that are easier to miss. |
| •Never give food, drink or aspirin while you wait for help. |
| •Treatment works best within hours, so always note when the symptoms began. |
A stroke can happen to anyone, at any age, and it often happens without warning. According to the Heart and Stroke Foundation South Africa, 10 people in South Africa have a stroke every hour. About a third of them will die, and a quarter will be left with a disability that changes their life.
What makes a stroke so dangerous is that it is usually painless. People often feel a little strange, sit down and wait for it to pass, losing precious time. The good news is that you don’t need any medical training to spot one. In this guide, we’ll walk you through the warning signs, what to do in the first few minutes, and how your health cover can help.
What is a stroke?
A stroke happens when the blood supply to part of your brain is cut off. Without oxygen-rich blood, brain cells begin to die within minutes. That’s why doctors sometimes call it a “brain attack”. There are two main types:
| Type of stroke | What happens |
|---|---|
| Ischaemic stroke | A blood clot or fatty build-up blocks a blood vessel in the brain. This is the most common type. |
| Haemorrhagic stroke | A blood vessel in the brain bursts and bleeds into the surrounding tissue. |
There is also a transient ischaemic attack (TIA), often called a mini-stroke. We explain it further down, because it is a warning sign you should never ignore.
The signs of a stroke: BE FAST
BE FAST is a simple way to remember the most common signs of a stroke. Each letter stands for a sign to look for, with a quick check you can do on the spot.
| B | BalanceSudden dizziness, loss of balance or trouble walking. Check: can they stand and walk the way they normally would? |
| E | EyesSudden blurred or double vision, or loss of sight in one or both eyes. Check: ask if their vision has suddenly changed. |
| F | FaceOne side of the face droops or feels numb. Check: ask them to smile. Is the smile uneven? |
| A | ArmsOne arm feels weak or numb. Check: ask them to raise both arms. Does one drift downwards? |
| S | SpeechSpeech is slurred, muddled or strange. Check: ask them to repeat a simple sentence. Can they say it clearly? |
| T | TimeIf you see any of these signs, even just one, it’s time to call 082 911 or 112. Make a note of the time the symptoms started. |
You may have seen the shorter FAST version used by the Heart and Stroke Foundation South Africa. BE FAST adds balance and eyes, because strokes at the back of the brain don’t always affect the face, arms or speech.
Other stroke symptoms to watch for
Not every stroke looks the same. The signs depend on which part of the brain is affected. Watch for any of the following, especially when they come on suddenly:
| •Confusion, or trouble understanding what other people are saying |
| •Numbness or weakness in one leg, or down one side of the body |
| •A sudden, severe headache with no known cause, sometimes with vomiting |
| •A spinning feeling (vertigo), nausea or trouble swallowing |
| •Sudden drowsiness or loss of consciousness |
Many of these symptoms can have other causes, such as a migraine or an inner ear problem. If they appear suddenly or together, treat it as a stroke until a doctor says otherwise. You can read more in our guides to what causes dizzy spells, types of headaches and migraines and vision problems.
Signs of a stroke in women
Women have the same BE FAST signs as men, but they may also have symptoms that are easier to brush off, such as:
| •General weakness or tiredness |
| •Confusion or memory problems |
| •Nausea or vomiting |
Because these can feel like stress, a stomach bug or plain exhaustion, women sometimes wait longer before getting help. Some factors also raise stroke risk for women in particular:
| •Pregnancy and the weeks after giving birth |
| •Hormone therapy or contraceptive pills that contain oestrogen |
| •Migraines with aura, especially if you also smoke |
If you’re not sure whether any of these apply to you, raise them with your GP at your next visit. For more on looking after yourself, see our guides to common women’s health problems and health insurance for women.
Mini-stroke (TIA): warning signs that go away
A TIA happens when blood flow to part of the brain is blocked for a short time. The signs are the same as a stroke, but they usually last a few minutes and disappear completely within 24 hours.
It’s tempting to feel relieved and carry on with your day. Please don’t. A TIA is often a warning that a full stroke could follow, sometimes within days. Call 082 911 even if the symptoms have gone, and tell the paramedics or doctor exactly what happened and when.
After a TIA, doctors will look for the cause, such as high blood pressure, an irregular heartbeat or narrowed arteries, and start treatment to lower your risk of a stroke.
What to do if someone is having a stroke
Acting quickly and calmly can make a real difference. Here’s what to do, step by step:
| 1 | Call for an ambulance straight awayPhone 082 911, or 112 from a cellphone. Don’t drive the person to hospital yourself. Paramedics can start treatment on the way and take them to a hospital equipped to treat strokes. |
| 2 | Note the timeWrite down when the symptoms started, or the last time the person was seen well. Doctors use this to decide which treatments are safe. |
| 3 | Keep them safe and comfortableIf they’re awake, help them lie on their side with their head slightly raised and supported. Loosen tight clothing, and support any weak arm or leg without pulling on it. |
| 4 | Don’t give them anything by mouthNo food, no water and no medicine, including aspirin. A stroke can affect swallowing, and some strokes are caused by bleeding that aspirin can make worse. |
| 5 | Watch their breathingStay with them and keep talking calmly. If they stop responding and aren’t breathing normally, start CPR. The call taker can talk you through it. |
| 6 | Gather important informationFind a list of their medicines and medical conditions, their ID and their medical aid or health insurance card. Health4Me members have a digital membership card on the Momentum App. |
| 7 | Get authorisation once help is on the wayHealth4Me emergency cover needs pre-authorisation. Once the ambulance is on its way, the member or a family member should call 0860 10 29 03 for authorisation. |
If you think you’re having a stroke yourself
Call 082 911 or 112 immediately, even if you’re not sure. Unlock your front door if you can, then sit or lie down somewhere safe. Don’t try to drive. If anyone is nearby, tell them what’s happening so they can help.
Why every minute counts
With a stroke, time really is brain. The sooner a person reaches hospital, the more options doctors have to restore blood flow and limit lasting damage.
| Time since symptoms started | What it can mean for treatment |
|---|---|
| Within 3 hours | The Heart and Stroke Foundation South Africa advises reaching hospital within this time, so that treatment to restore blood flow is possible. |
| Up to 4.5 hours | Clot-busting medicine can usually still be given for strokes caused by a clot. |
| Up to 6 hours | Doctors may be able to remove the clot with a procedure called a thrombectomy. |
| Up to 24 hours | Some people may still qualify for clot removal after scans. |
Before any treatment, doctors will do a brain scan to find out whether the stroke is caused by a clot or a bleed, because the treatments are very different. They also need to know exactly when the symptoms began. If nobody saw it start, tell them the last time the person was seen well.
Who is at risk of a stroke?
Anyone can have a stroke, but some things make it more likely.
| Risks you can manage | Risks you can’t change |
|---|---|
| •High blood pressure•High cholesterol•Diabetes•An irregular heartbeat (atrial fibrillation)•Smoking•Heavy drinking•Not being active•Carrying extra weight•Sleep apnoea | •Age, as risk rises after 55•A family history of stroke•A previous stroke, TIA or heart attack |
The Heart and Stroke Foundation South Africa says up to 70% of strokes can be prevented through healthy habits. High blood pressure is one of the biggest risks, and it often has no symptoms, so regular checks really matter. Start with our tips to lower blood pressure naturally, learn how to monitor your blood pressure at home, and read up on heart arrhythmia, diabetes and the effects of smoking.
How Health4Me helps if a stroke happens
Health4Me’s accident and emergency cover includes strokes and heart attacks that need immediate medical treatment and meet the qualifying criteria, at a private hospital. Here’s how it supports you in an emergency, during recovery and before anything happens.
In an emergency
Subject to clinical approval and the per-event limits, emergency cover for a stroke includes:
| •Emergency transport, stabilisation and treatment |
| •A casualty benefit and an in-hospital benefit for each event |
| •Diagnostic scans such as CT and MRI scans |
| •Take-home medication |
| •Prosthetics and assistive devices |
| •Rehabilitation services such as wound care, physiotherapy and occupational therapy |
Good to know
Emergency cover is part of the major medical event benefits, available on the Base and Standard options. These are added to your Bronze, Silver or Gold day-to-day option and can’t be taken on their own. The Standard option has higher limits.
Pre-authorisation is required. If the benefit limit is reached and more treatment is needed, you’ll be moved to a state facility for further care.
If you are in hospital for longer than 48 hours, the hospital cash benefit pays a daily amount from day one, which can help with costs at home while you recover. Waiting periods apply.
During recovery
Recovering from a stroke can take months. Many people need physiotherapy, occupational therapy or speech therapy to regain their strength and independence. Health4Me’s emergency cover includes rehabilitation services such as physiotherapy and occupational therapy, subject to clinical approval.
It’s also common to feel low or anxious after a stroke, both for survivors and for the people caring for them. Health4Me members have free access to the Employee Assistance Programme, which offers telephonic counselling and support for adults, teenagers and children.
Before: keeping your risk low
Health4Me’s day-to-day benefits help you keep on top of the risks that lead to a stroke:
| •A yearly health assessment that checks your blood pressure, cholesterol and blood sugar, plus your height, weight and waist, at a Wellness Day or a pharmacy clinic such as Dis-Chem, Clicks or MediRite. Your result also gives you a Healthy Heart Score, which can earn you monthly More4Me rewards. |
| •Unlimited GP visits at a Network GP, so you can see a doctor when something doesn’t feel right. |
| •Unlimited Hello Doctor consultations by chat, phone or video call, 24 hours a day. |
| •Chronic cover for 27 conditions, including hypertension, hyperlipidaemia (high cholesterol), type 1 and type 2 diabetes, cardiac dysrhythmias and coronary artery disease. Pre-authorisation and waiting periods apply. |
You can see how the options compare on our benefits page or learn more about Health4Me health insurance.
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Cover for the moments that can’t wait Health4Me’s emergency cover helps with private hospital care for qualifying strokes and heart attacks, alongside unlimited GP and Hello Doctor visits for everyday health. Find the option that suits your needs and budget. |
Frequently asked questions
What are the first signs of a stroke?
The first signs are usually sudden: a drooping face, weakness in one arm, slurred speech, loss of balance or a change in vision. Use BE FAST to check, and call 082 911 or 112 at the first sign.
What number should I call for a stroke in South Africa?
Call 082 911 for emergencies. You can also dial 112 from any cellphone or 10177 for the national ambulance service. Tell the call taker you think it is a stroke and when the symptoms started.
Is a stroke painful?
Usually not, which is why many people wait for it to pass. The exception is a sudden, severe headache with no known cause. This can be a sign of bleeding in the brain and needs emergency care.
How long do stroke symptoms last?
Without fast treatment, the effects of a stroke can be permanent. The symptoms of a mini-stroke (TIA) usually clear within minutes and always within 24 hours, but a TIA still needs emergency care.
Can you have a stroke and not know it?
Yes. A silent stroke causes no obvious symptoms and is usually found on a brain scan done for another reason. Silent strokes raise the risk of a future stroke, so managing risks such as high blood pressure matters.
Should I give aspirin to someone having a stroke?
No. Some strokes are caused by bleeding in the brain, and aspirin can make bleeding worse. Don’t give the person any medicine, food or drink. Doctors will do a scan to find out what type of stroke it is.
What is the difference between a stroke and a heart attack?
A stroke happens when blood flow to the brain is cut off. A heart attack happens when blood flow to the heart is blocked. Both are emergencies, and Health4Me’s emergency cover includes both when they meet the qualifying criteria.
Can young people have a stroke?
Yes. Strokes are more common after the age of 55, but they can happen at any age. High blood pressure, diabetes, smoking, heavy drinking and drug use all raise the risk, even in younger adults.
Does health insurance cover a stroke?
Health4Me’s accident and emergency cover pays for qualifying strokes at a private hospital, including emergency transport, casualty and in-hospital treatment, up to per-event limits. It is available on the Base and Standard major medical event options, and pre-authorisation is required.
Final thoughts
Knowing the signs of a stroke is one of the simplest ways to protect the people you love. Share BE FAST with your family, save 082 911 in your phone, and keep up with your yearly health checks. If you’d like to know more about emergency cover, compare our options or ask for a call back and our team will gladly help.
Disclaimer: This article is for general information only and does not replace medical advice. If you think someone is having a stroke, call 082 911 or 112 immediately.
Momentum Health4Me is not a medical scheme product and is not a substitute for medical scheme membership. Benefits are subject to the product terms and conditions, including pre-authorisation, waiting periods and benefit limits.
