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Timeline of a Stroke

Driving home from dinner, you glance over at your husband and you know something isn’t right. His right arm appears limp—paralyzed even. His speech is slurred. And his mouth is drooping.

What is happening?

Learn more about Stroke Care at Gwinnett Medical Center

If you said he might be having a stroke, you’re right.

Here’s a closer look at what happens during a stroke, from the experts at Gwinnett Medical Center — and what you need to know about our country’s leading cause of disability and the third most frequent cause of death in Georgia.

The First Minute
Your brain needs blood and oxygen to function. During a stroke, a blood vessel responsible for taking oxygen and nutrients to the brain is affected in one of two ways.

The first kind of stroke is called hemorrhagic, which happens when a blood vessel bursts.
The more common type is called an ischemic stroke, says Arun Lakhanpal, MD, Gwinnett Medical Center’s inpatient neurologist. During an ischemic stroke, a clot blocks a blood vessel and blood can’t get to the brain.

“In ischemic strokes, the brain may continue to get some blood through back channels (collaterals),” Dr. Lakhanpal says. “That may allow the tissue to survive for tens of minutes to a few hours.”

But every minute that goes by, 2 million brain cells die. That’s why experts say that “time lost is brain lost.” It’s also why it’s important to get help right away.

When blood flow to the brain stops, the symptoms come on suddenly. The most common signs follow the memory guide FAST: F: Facial drooping A: Arm weakness S: Speech difficulty T: Time. If any of the previous three signs is present, call 911.

The First Hour
For people who have had an ischemic stroke, a drug called tPA can be given to bust the clot. The first hour after the onset of symptoms is known as the “golden hour.” That’s when the drug has shown the most benefit—helping to restore blood flow and prevent further cognitive and physical problems.

It might be tempting to drive your loved one to the hospital. But calling 911 is a better option. Emergency medical responders will begin tests on the way to the hospital.

The First Three Hours While getting treatment within the first hour is best, the window might be a little wider for some.

“The clot-busting drug tPA is approved for use up to three hours,” Dr. Lakhanpal says. “But it shows some benefits up to 4.5 hours’’ in some patients.

So, if you think someone is having a stroke, don’t wait to see whether the symptoms go away on their own. The longer you wait, the greater the risk of long-term brain damage and death.

At Gwinnett Medical Center, we are nationally recognized leaders in stroke care, with multiple accreditations and awards. To learn more about our comprehensive stroke care, visit