Stroke (Apoplexy) Recognize and Help
High blood pressure increases the risk of having a stroke medically called an apoplexy. Other names are cerebral stroke or brain stroke historically also called "Schlagfluss" and commonly just "stroke." Stroke is the third most common cause of death in Germany. Most strokes are caused by a blood clot, often related to atrial fibrillation. Atrial fibrillation itself is commonly linked to high blood pressure. While strokes mainly affect older people, children, adolescents and young adults can also have a stroke.
A 2024 study showed that high blood pressure especially raises the risk of a severe stroke. A stroke is considered severe if the person can no longer walk or care for themselves afterwards, or if they die as a result. Seventy-four percent of those who had a severe stroke had high blood pressure. Even those with mild to moderate strokes often had a prior diagnosis of hypertension. The study also found an increased risk, though smaller, for participants with atrial fibrillation or who were smokers.
A 2024 study showed that high blood pressure especially raises the risk of a severe stroke. A stroke is considered severe if the person can no longer walk or care for themselves afterwards, or if they die as a result. Seventy-four percent of those who had a severe stroke had high blood pressure. Even those with mild to moderate strokes often had a prior diagnosis of hypertension. The study also found an increased risk, though smaller, for participants with atrial fibrillation or who were smokers.
What is a stroke?
A stroke is a disturbance of blood flow in the brain. As a result, brain cells in the affected area get too little oxygen and nutrients and die. There are two main types of stroke: ischemic (non-bleeding) stroke and hemorrhagic (bleeding) stroke.
Ischemic (non-bleeding) stroke
This is an acute lack of blood flow (ischemia), often caused by a blood clot. This type accounts for about 80 to 85 percent of all strokes. How severe the stroke is depends on which part of the brain is affected by the reduced blood flow.
Hemorrhagic (bleeding) stroke
In this type the blood-flow problem is caused by bleeding in the brain. Because the brain is protected by the skull from external pressure or bumps, a bleed inside the brain cannot show up as a bump on the head. The escaping blood presses on the brain and causes reduced blood flow or the downstream area suffers from reduced blood flow because blood is missing. This causes 15 to 20 percent of strokes.
How do I recognize a stroke?
Certain signs are often seen with a stroke.
The best-known sign is weakness on one side of the body, recognizable by these symptoms:
- drooping mouth corner, drooping eyelid for example, drinks or saliva may run out of the mouth;
- an arm feels weak, cannot be lifted and the palm cannot be turned up;
- slurred or unclear speech and/or trouble understanding what's said;
- unsteady walking, problems when walking, one leg not cooperating.
Affected people may also have the following problems:
- loss of balance, dizziness;
- one-sided loss of part of the visual field certain areas of normal vision can no longer be perceived;
- double vision or blurred vision;
- sudden severe headache;
- nausea, possibly vomiting (warning: risk of choking!);
- confusion, disorientation questions about name, date of birth, today's date or location may not be answered or only poorly;
- reduced consciousness up to unconsciousness.
What to do if you suspect a stroke?
If you suspect that you or the person in front of you is having a stroke, call the emergency number immediately: 112! "Time is brain"!
Follow the FAST scheme:
F Face: Ask the person to smile. If one side of the face does not move when smiling, or a mouth corner or eyelid droops, a paralysis suggesting a stroke is likely.
A Arms: Ask the person to stretch their arms forward and turn the palms up either one arm at a time or both at once. If one arm hangs down limp, a paralysis indicating a stroke is likely.
S Speech: Ask the person to repeat a sentence or ask a simple question. If their speech is slurred or unclear and/or they cannot say their name or date of birth, this is a sign of a stroke.
T Time: Dont waste time! If you notice any signs in F, A, or S, call the emergency number immediately at 112. "Time is brain"!
A Arms: Ask the person to stretch their arms forward and turn the palms up either one arm at a time or both at once. If one arm hangs down limp, a paralysis indicating a stroke is likely.
S Speech: Ask the person to repeat a sentence or ask a simple question. If their speech is slurred or unclear and/or they cannot say their name or date of birth, this is a sign of a stroke.
T Time: Dont waste time! If you notice any signs in F, A, or S, call the emergency number immediately at 112. "Time is brain"!
Stay with the person, position them with their upper body elevated, and keep observing them. Do not let them eat or drink the risk of choking due to the paralysis is high! If necessary, give first aid. If the person becomes unconscious but is still breathing, place them in the recovery position. Check breathing repeatedly. If they stop breathing, start cardiopulmonary resuscitation (CPR).
If you are affected yourself, if possible get the nearest person to you. Wake your partner, call a neighbor, notify your children or relatives. Do everything to avoid being alone. Do not eat or drink! Do not strain yourself!
Wait for the emergency services! Do not drive yourself to the hospital! Doing so endangers you and others.
What else is important?
Open the door for the arriving emergency team. You can wedge a shoe or something similar in the door to keep it from closing. Be prepared that the situation may worsen before the ambulance arrives, so you might not be able to open the door then.
For emergencies like a stroke, it's helpful to have a current medication list and any known allergies available.
"Time is brain" time is brain. That means the faster a stroke can be treated by doctors, the better the chances of survival and of avoiding lasting damage. The best window for starting so-called thrombolytic (clot-busting) therapy is up to 4.5 hours after the stroke.
What happens next?
The ambulance will get the person to the hospital as quickly as possible preferably to a stroke unit. In remote areas this may mean an air ambulance is needed. A stroke unit is a specialized ward for stroke patients.
At the hospital a CT (computed tomography) scan of the head will be done. This imaging shows if, where, what type and how severe the stroke is. Treatment is started depending on the findings possibly thrombolysis to dissolve the clot blocking the vessel.
At the hospital a CT (computed tomography) scan of the head will be done. This imaging shows if, where, what type and how severe the stroke is. Treatment is started depending on the findings possibly thrombolysis to dissolve the clot blocking the vessel.
Smile speak arms up
Cartoonist Ralph Ruthe made a humorous music video about this serious topic. Humor helps remember the symptoms:
https://www.youtube.com/watch?v=SmZZLGnbWxc
https://www.youtube.com/watch?v=SmZZLGnbWxc
Sources:
- https://www.netdoktor.de/krankheiten/schlaganfall/
- https://www.msdmanuals.com/de/heim/störungen-der-hirn-,-rückenmarks-und-nervenfunktion/schlaganfall-cva/Überblick-über-den-schlaganfall
- https://www.drk.de/hilfe-in-deutschland/erste-hilfe/schlaganfall/
- https://www.neurology.org/doi/10.1212/WNL.0000000000210087
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2025).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
