Stroke (apoplexy): how to recognize it and how to help
High blood pressure increases the risk of having a stroke medically called an apoplexy. Other names are cerebral stroke or brain stroke in the past sometimes called "Schlagfluss" and in everyday speech often just "stroke." Stroke is the third most common cause of death in Germany. Most strokes are caused by a blood clot, often due to atrial fibrillation. Atrial fibrillation is frequently linked to high blood pressure. While strokes mainly affect older people, children, teenagers and young adults can also have a stroke.
A 2024 study showed that high blood pressure particularly increases the risk of a severe stroke. A stroke is classed as severe when the person can no longer walk or take care of themselves afterward, or when the event leads to death. 74% of those who had a severe stroke had high blood pressure. Even those who had a mild to moderate stroke 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 particularly increases the risk of a severe stroke. A stroke is classed as severe when the person can no longer walk or take care of themselves afterward, or when the event leads to death. 74% of those who had a severe stroke had high blood pressure. Even those who had a mild to moderate stroke 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 caused by a circulation disorder in the brain. As a result, brain cells in the affected area receive 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
An acute lack of blood flow (ischemia) occurs often caused by a blood clot. This form accounts for about 80 to 85 percent of all strokes. How severe the stroke is depends on which part of the brain is affected.
Hemorrhagic (bleeding) stroke
In this form the circulation problem is due to bleeding in the brain. Because the brain is protected by the skull, a brain bleed cannot form a visible bump outward the leaking blood presses on the brain and causes reduced blood flow, or the downstream area receives too little blood. This accounts for 15 to 20 percent of strokes.
How do I recognize a stroke?
Certain signs are very common with a stroke.
The most well-known sign is weakness on one side of the body, which can be recognized by these symptoms:
- drooping mouth corner, drooping eyelid for example, drinks or saliva may dribble out of the mouth;
- an arm feels weak, cannot be lifted and the palm cannot be turned upward;
- slurred or unclear speech and/or difficulty understanding spoken words;
- unsteady walking, trouble walking, one leg not cooperating.
People may also have the following problems:
- loss of balance, dizziness;
- partial loss of the visual field on one side certain areas of normal sight can no longer be perceived;
- double vision or blurred vision;
- sudden severe headache;
- nausea, possibly vomiting (Caution: risk of choking!);
- confusion, disorientation questions about name, date of birth, today's date and location may not be answered or only incompletely;
- reduced consciousness up to loss of consciousness.
What to do if you suspect a stroke?
If you suspect that you or the person in front of you may be having a stroke, call the emergency number 112 immediately! „Time is brain“!
Follow the FAST method:
F – Face: Ask the person to smile. If one side of the face doesn't move with the smile, or a mouth corner or eyelid droops, a weakness is likely and may indicate a stroke.
A – Arms: Ask the person to stretch both arms forward and turn the palms up either one arm at a time or both together. If one arm falls limp, a weakness is likely and may indicate a stroke.
S – Speech: Ask the person to repeat a sentence or ask a simple question. If speech is slurred or unclear and/or the person cannot give basic information like their name or date of birth, this is a sign of a stroke.
T – Time: Don't waste time! If you notice any abnormalities in F, A or S, call the emergency number 112 right away. „Time is brain“!
A – Arms: Ask the person to stretch both arms forward and turn the palms up either one arm at a time or both together. If one arm falls limp, a weakness is likely and may indicate a stroke.
S – Speech: Ask the person to repeat a sentence or ask a simple question. If speech is slurred or unclear and/or the person cannot give basic information like their name or date of birth, this is a sign of a stroke.
T – Time: Don't waste time! If you notice any abnormalities in F, A or S, call the emergency number 112 right away. „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 weakness is high! Provide first aid if needed. If the person becomes unconscious but is breathing, place them in the recovery position. Check breathing repeatedly. If they stop breathing, begin CPR.
If you are the one affected, and it is possible, call someone nearby for help. Wake your partner, call a neighbor, inform your children or relatives. Do everything you can not to be alone in this situation. Do not eat or drink! Do not exert yourself!
Wait for the ambulance! Do not drive yourself to the hospital! You could put yourself and others at risk..
What else is important?
Open the door for the arriving emergency team. You can wedge a shoe or similar object in the door to keep it from closing. Be prepared that the situation may worsen before the ambulance arrives, so you might later be unable to open the door.
For emergencies like a stroke, it's helpful to have an up-to-date list of medications and any allergies noted. A great option for storing these documents for example a medication list or a doctor's letter with known diagnoses is the so-called Notfalldose (emergency canister). It is available in pharmacies, medical supply stores or online. You put the documents or copies into the canister and then place it in the refrigerator door. A sticker on the inside of the house or apartment door indicates the presence of the emergency canister. This way, emergency personnel can quickly find the important information. You should of course keep the canister's contents up to date and note any changes in medication, new diagnoses or allergies there as well.
„Time is brain“ time is brain. That means the faster a stroke can be treated medically, the better the chances of survival and of having as few lasting impairments as possible. The best window to start a so-called thrombolytic (clot-busting) treatment is up to 4.5 hours after the stroke.
What happens next?
The ambulance will take the person to the hospital as quickly as possible preferably to a stroke unit. In remote areas this may require an air ambulance. A stroke unit is a specialized ward for stroke patients.
In the hospital, a CT (computed tomography) scan of the head will be done. This imaging shows whether, where, what type and how severe the stroke is. Depending on the findings, treatment will be started possibly thrombolysis to dissolve the clot blocking the vessel.
In the hospital, a CT (computed tomography) scan of the head will be done. This imaging shows whether, where, what type and how severe the stroke is. Depending on the findings, treatment will be started possibly thrombolysis to dissolve the clot blocking the vessel.
Smile speak arms up
Cartoonist Ralph Ruthe made a funny music video about this serious topic. Humor helps to 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
- https://www.notfalldose.de/
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands of people monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based information and is continuously updated (as of 04/2026).
Author Sabine Croci is a certified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care. Since 2015 she has led the editorial team at BloodPressureDB. With additional qualifications as a paramedic, first responder, and training in various therapy and emergency areas, she provides well-founded, practical, and reliably reviewed information.
Author Sabine Croci is a certified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care. Since 2015 she has led the editorial team at BloodPressureDB. With additional qualifications as a paramedic, first responder, and training in various therapy and emergency areas, she provides well-founded, practical, and reliably reviewed information.
