Every Minute Matters: Recognizing, Preventing and Responding to Stroke

In commemoration of World Stroke Day – 29 October 2026

By Dr Aung Tun

A sudden emergency that de­mands action

A person talking normally at breakfast may suddenly struggle to speak, drop a cup or find that one side of the body will not move. Family members may hope that rest will help. Yet these changes can signal a stroke, and waiting can cost precious opportunities for treatment. Stroke is a medical emergency. Recognizing the signs and seeking help immediately can save lives and reduce disability.

World Stroke Day, observed on 29 October, provides an oppor­tunity to bring this message into every home. The World Stroke Organization’s 2026 campaign, “Every M1nute Counts”, urges people to recognize symptoms and act FAST. For Myanmar, aware­ness should connect emergency action with everyday prevention and compassionate support for survivors.

Understanding what happens in the brain

A stroke occurs when a blood vessel supplying the brain be­comes blocked or ruptures. An ischaemic stroke results from interrupted blood flow, usually because of a clot. A haemorrhag­ic stroke involves bleeding in or around the brain. Both require urgent medical assessment, but their treatments differ. Symptoms alone cannot reliably distinguish them; brain imaging is essential.

A transient ischaemic attack, or TIA, causes temporary stroke-like symptoms that resolve. Dis­appearance of symptoms does not mean that the danger has passed. A TIA can warn of a subsequent stroke and requires emergency assessment. Neither a mild epi­sode nor a rapid recovery should encourage a family to postpone care until the following day.

A global challenge with les­sons for Myanmar

WHO reports that there were approximately 11.9 million new strokes worldwide in 2021. These are estimates for that year, rather than a count for 2026. Behind the figures are people who lose mo­bility, communication skills, em­ployment or independence, and families who take on prolonged caregiving responsibilities.

Myanmar’s STEPS Survey 2024 helps explain the prevention challenge. Among adults aged 18-69, 24.4 per cent had raised blood pressure or were taking medica­tion for it, and 7.9 per cent had raised fasting blood glucose or were receiving diabetes medica­tion. These are risk-factor find­ings, not measurements of stroke incidence. They support a practi­cal priority: identify and manage vascular risk before an emergency occurs.

Recognizing warning signs with BE FAST

Stroke symptoms usually be­gin suddenly. The reminder BE-FAST broadens the familiar FAST message to include problems with balance and vision:

B — Balance: sudden loss of balance, coordination or ability to walk.

E — Eyes: sudden loss of vision, blurred vision or double vision.

F — Face: one side of the face droops, especially when smiling.

A — Arms: an arm becomes weak or numb, or drifts downward when both are raised.

S — Speech: speech becomes slurred, unusual or difficult to un­derstand; the person may struggle to find words.

T — Time: seek emergency medical help immediately.

Other warnings include sud­den one-sided leg weakness or a severe unexplained headache. Not every stroke produces every sign. One sudden warning can be enough to act. A painless stroke is still an emergency, and a person who remains conscious may nev­ertheless have serious brain injury.

What families should do im­mediately

Contact the locally available ambulance or emergency medical service and explain that a stroke is suspected. Where an ambulance cannot be accessed promptly, arrange the fastest safe assisted transport to an emergency hospi­tal, preferably one able to assess stroke and perform brain imaging. The affected person should not drive.

Record when symptoms be­gan and when the person was last known to be normal. This is especially important if symptoms are discovered on waking. Bring a medication list if readily availa­ble, but do not delay departure to collect paperwork.

Do not offer food, drinks or tablets until swallowing safety has been assessed. Do not give aspi­rin on your own: it can worsen a bleeding stroke. Avoid massage or home remedies that delay assess­ment. Stay with the person and follow emergency instructions. If symptoms disappear during the journey, continue to seek urgent evaluation.

Emergency preparedness is particularly useful for people who live alone. Relatives and neighbours can agree on whom to contact and how to arrange as­sistance. A simple written list of medicines and emergency con­tacts can help, provided finding it does not delay transport.

Knowing who is at risk

High blood pressure is a major preventable contributor to stroke. It can damage blood vessels for years without causing noticeable symptoms. Diabetes, high cholesterol, tobacco use, physical inactivity, excess body weight and harmful alcohol use also contribute to risk. Exposure to second-hand smoke and air pol­lution matters as well.

Atrial fibrillation, an irregular heart rhythm, can allow clots to form in the heart and travel to the brain. Appropriate medical assess­ment and, when indicated, antico­agulant treatment can reduce this risk. Aspirin is not a substitute for prescribed anticoagulation.

Risk increases with age and previous stroke, but younger adults can also be affected. Pre­vention should therefore be dis­cussed across adulthood, rather than reserved for older people.

Turning prevention into daily habits

Knowing blood pressure is a useful starting point. Repeated, correctly taken measurements and professional assessment help establish whether treatment is needed. People already prescribed medicines should take them con­sistently and attend follow-up, even when they feel well. Diabetes and cholesterol care should form part of the same prevention plan.

Choose more vegetables, fruit, pulses and whole grains, while reducing salty foods, exces­sive sauces and highly processed snacks. Avoid tobacco and keep homes free of tobacco smoke. Aim for at least 150 minutes of moderate physical activity weekly, ad­justed to health and ability. Walking regularly can be a realistic starting point.

Small household changes can make healthy choices easier. Families can gradually use less salt in cooking, plan shared walks and help older rel­atives obtain prescribed medicines. Workplaces and community groups can link screening with counselling and continu­ing care. A screening result has little value if an abnor­mal finding never leads to treatment or follow-up.

People should ask their clinician about per­sonal targets and the ap­propriate frequency of checks. Keeping a record of results can make follow-up more useful. Prevention is a continuing partnership: patients need understand­able advice, while services need to make repeated vis­its and essential medicines accessible.

Treatment depends on speed and assessment

At hospital, clini­cians assess symptoms, check vital signs and use CT or MRI to determine the stroke type. Eligible patients with ischaemic stroke may receive clot-dis­solving medication, gener­ally within

4.5 hours. Selected patients may qualify later after specialist assessment and appropriate imag­ing. Certain large-vessel blockages can be treated by mechanical thrombec­tomy, sometimes up to 24 hours in carefully selected patients.

These windows are not permission to wait. Eligibility depends on clinical findings, imaging, timing and available ser­vices; earlier treatment remains crucial. Bleeding strokes require different management, potentially including blood pressure control, specialist moni­toring and surgery. Organ­ized stroke care also helps prevent complications and establish a recovery plan.

Recovery deserves sus­tained support

Survival is the begin­ning of another important phase. Rehabilitation can help restore movement, communication, swallow­ing and daily living skills. It should begin when medically appropriate and continue according to in­dividual needs. Progress differs between people, and support should be based on realistic goals rather than promises of complete re­covery.

Families can help by learning safe assistance techniques, encourag­ing prescribed exercises and attending follow-up appointments. Difficulty speaking does not mean that a survivor has lost intelligence. Allow time for responses and include the person in decisions. Depression, anxiety and caregiver exhaustion also deserve attention. Reha­bilitation should protect dignity and participation alongside physical func­tion.

Before discharge, families should ask for a clear care plan covering medicines, follow-up, re­habilitation and warning signs. They should also un­derstand whom to contact if new symptoms develop. Making the home safer and sharing caregiving respon­sibilities can support recov­ery while reducing avoida­ble strain on the household during the months that fol­low discharge.

Making awareness use­ful beyond one day

For World Stroke Day 2026, health workers, teach­ers, employers and com­munity organizations can teach BE-FAST through short demonstrations. A useful session should an­swer two questions:

participants recog­nize a sudden warning, and do they know how to reach emergency care locally? Posters become more ef­fective when accompanied by a practical transport and referral plan.

Every family can begin today by discussing stroke signs, identifying an emer­gency hospital and keeping essential health informa­tion accessible. Prevention requires continuing hab­its and medical care; an emergency requires imme­diate action. When stroke is suspected, do not wait for certainty. Recognize the change, seek help and give the person the best possi­ble chance of recovery.

References

1. World Health Organ­ization. Stroke. Fact sheet. 19 December 2025. https://www. who.int/news-room/ fact-sheets/detail/ stroke

2. Ministry of Health, Myanmar. STEPS Survey Myanmar 2024. Final Report. Tables 3.13.4 and 3.14.3, pp. 98-99 and 108.

3. World Stroke Organ­ization. World Stroke Day 2026: EVERY M1NUTE COUNTS #ActFAST. 4 Septem­ber 2026.

4. American Heart As­sociation and Amer­ican Stroke Associa­tion. 2026 Guideline for the Early Man­agement of Patients with Acute Ischemic Stroke. 2026.

5. American Stroke Association. Public education resourc­es: Stroke Symptoms and Warning Signs; Transient Ischemic Attack; Aspirin and Stroke, Stroke Re­hab. Accessed 8 Oc­tober 2026.