A stroke is one of the diagnoses where hours matter most, and one of the hardest to be sure about in the moment. Some strokes announce themselves plainly; others arrive as dizziness, a headache, or symptoms that come and go. This guide helps you organize what happened when a stroke was not recognized right away — as questions to bring, not conclusions to reach. The delayed-diagnosis guide covers the general approach; this page adds what is particular to stroke.

The short answer

Stroke questions almost always come down to the clock: when the symptoms started, when help was sought, what was examined and ordered, and whether the stroke was identified while treatment was still possible. The National Institute of Neurological Disorders and Stroke (NINDS) describes the most effective stroke treatments as time-limited, with windows measured in hours from the first symptoms. Whether an earlier diagnosis would have changed what could be done, and whether the delay reflects a problem with the care rather than the nature of the stroke, is a question for medical and legal review. Your part is to pin down the times.

When did it start? “Last known well”

NINDS advises noting the time a person first shows symptoms, because it helps doctors decide on treatment, and emergency doctors will ask when symptoms began. When no one saw the start — a person who woke up with symptoms, or was found confused — hospitals work from the last time the person was known to be normal, often charted as “last known well.” Write down:

  • The last time you or a family member is sure the person was acting normally, and how you know (a phone call, a text, a conversation).
  • The first moment something seemed wrong, and what it was.
  • When 911 was called or the person arrived at an emergency department or urgent care, and how they got there.

Phone call logs, text timestamps, and ambulance records often fix these times better than memory. Keep them.

Symptoms that are easy to miss

The familiar warning signs are a drooping face, arm weakness, and trouble speaking. The American Stroke Association and the CDC also list sudden loss of balance or dizziness and sudden vision changes, and NINDS and the CDC list a sudden severe headache with no known cause. The American Stroke Association notes that strokes in the back of the brain can look quite different from the classic picture — vertigo, imbalance, double vision, headache, nausea or vomiting. An AHRQ-sponsored review of emergency-department diagnosis (December 2022) named stroke among the conditions most vulnerable to misdiagnosis.

If the first visit was for dizziness, a headache, or “feeling off,” note:

  • Exactly how the symptoms were described to staff, and by whom.
  • What diagnosis you were given (for example, an inner-ear problem, migraine, or anxiety) and what discharge instructions said.
  • Whether anyone checked walking, eye movements, or coordination.

Symptoms that went away

NINDS warns that stroke symptoms lasting only a few minutes may be a transient ischemic attack (TIA), a warning sign of a serious condition. If symptoms came and went before the stroke, record each episode, whether you sought care, and what you were told about follow-up testing or medication.

Imaging and testing

NINDS describes brain imaging — CT and MRI — as central to diagnosing stroke, telling its types apart, and choosing treatment. A bleeding stroke has to be ruled out before clot-dissolving medicine is given, and NINDS notes that MRI can show some ischemic strokes, especially smaller ones and TIAs, more accurately and earlier than CT. Questions worth organizing:

  • Was a scan done? Which kind, and at what time relative to arrival?
  • If a scan was read as normal, was further imaging or a specialist consultation considered?
  • Were the results communicated, and to whom?

Treatment decisions

NINDS describes emergency treatments for the most common type of stroke that restore blood flow — clot-dissolving medicine and procedures to remove a clot — and notes that each depends on timing and on the type of stroke. You do not need to know which applied. It is enough to note whether anyone discussed these treatments with you, what reasons were given if they were not offered, and whether a transfer to another hospital was arranged and when.

Records and questions to bring

Bring your timeline, discharge papers from every visit (including any visit before the stroke was diagnosed), ambulance information, phone and text records that fix times, and a written list of unanswered questions. The full chart — triage notes, neurological checks, imaging reports and their timestamps — can be requested after a first conversation.

Timing

Connecticut’s general malpractice deadline, C.G.S. § 52-584, requires a claim within two years of when the injury was discovered or reasonably should have been, and no more than three years from the act or omission. If the person died, § 52-555 sets a different limit: two years from the date of death, and no more than five years from the act or omission. Section 52-190a requires a written opinion from a similar health care provider before filing and allows an automatic 90-day extension for that inquiry. How these rules apply to your dates is a question for a lawyer, so it is better to ask early.