Here are some signs that don’t fit neatly into the BEFAST acronym but should still raise red flags:

1. Sudden Severe Headache (Especially With Nausea or Vomiting)

• What it looks like: A sudden, intense “thunderclap” headache that feels unlike anything you’ve experienced before. It may be accompanied by nausea, vomiting, or blurred vision.
• Why it happens: This could be a sign of a hemorrhagic stroke, where a blood vessel in the brain bursts, causing bleeding. The pressure from the bleeding irritates the brain, leading to a sudden headache.
• When to act: If someone reports “the worst headache of their life,” it’s time to call 911. Don’t assume it’s just a migraine.

2. Sudden Confusion or Memory Problems

• What it looks like: Trouble thinking clearly, difficulty concentrating, or sudden memory loss. A person might get lost in familiar places or have difficulty following simple instructions.
• Why it happens: If a stroke affects the parts of the brain responsible for cognitive processing, it can disrupt thought patterns and memory. The frontal and parietal lobes are often affected.
• When to act: If someone seems disoriented, confused, or forgetful out of nowhere—especially if it’s accompanied by other symptoms like dizziness or vision changes—get medical attention immediately.

3. Sudden Difficulty Swallowing (Dysphagia)

• What it looks like: A person may choke on food, have difficulty drinking water, or be unable to swallow at all.
• Why it happens: Strokes that affect the part of the brain responsible for muscle control (like the medulla or brainstem) can weaken the muscles needed for swallowing.
• When to act: If someone has difficulty swallowing, especially if it’s accompanied by other stroke signs, get help. Dysphagia can also increase the risk of choking or pneumonia due to food entering the lungs.

4. Sudden Loss of Coordination or Clumsiness (Beyond Just Balance)

• What it looks like: Tripping while walking, dropping objects, or sudden clumsiness that wasn’t present before.
• Why it happens: Strokes that affect the cerebellum, which controls motor coordination and balance, can disrupt a person’s ability to move their limbs smoothly. This is different from general “balance issues” associated with BEFAST.
• When to act: If someone is suddenly uncoordinated or having trouble with fine motor skills, like buttoning a shirt or holding a pen, call 911.

5. Sudden Changes in Mood, Personality, or Emotional Control

• What it looks like: Someone may become unusually irritable, agitated, or emotionally reactive (e.g., crying for no reason or laughing inappropriately).
• Why it happens: A stroke in the brain’s frontal lobe (which controls personality, emotions, and social behavior) can trigger sudden emotional changes.
• When to act: If a person’s mood shifts drastically without an obvious cause, it’s worth seeking medical attention. People experiencing a stroke often don’t recognize their own behavioral changes, so it’s important for those around them to stay alert.

6. Blurred or Double Vision (Not Just Vision Loss)

• What it looks like: People may experience blurry or double vision in one or both eyes, sometimes paired with dizziness or balance issues.
• Why it happens: When a stroke affects the occipital lobe (which processes visual information), the brain’s ability to interpret vision is disrupted. Unlike BEFAST’s “vision loss” warning, blurred or double vision can seem less urgent—but it isn’t.
• When to act: If blurry or double vision comes on suddenly and doesn’t resolve quickly, call 911. Stroke-related vision problems won’t go away on their own.

7. Sudden Numbness or Tingling in Unusual Places

• What it looks like: Numbness or tingling sensations in areas like the fingers, toes, or even half of the face. People might describe it as “pins and needles.”
• Why it happens: Strokes that affect the somatosensory cortex (which processes sensory input) can cause tingling or numbness in the affected areas. This can feel different from the “arm weakness” seen in BEFAST.
• When to act: Numbness or tingling that comes on suddenly, especially if it occurs on one side of the body, warrants a 911 call. Even if it feels mild, it could signal a stroke in progress.