Like with many other health concerns, your risk of having a stroke increases as you get older. In fact, every 10 years after age 55, your stroke risk nearly doubles, according to the American Stroke Association.
But strokes can and do happen at any age–even, sometimes, in children. According to the Centers for Disease and Prevention (CDC), around a third of Americans hospitalized for strokes are younger than 65.
In 2016, social media star and model Katie May died was one of them. May died in February of that year after suffering a stroke. The New York Daily News reported that the 34-year-old had "tweaked her neck" when she fell during a photo shoot in late January, and that she had tweeted that she had "pinched a nerve" a few days before she was hospitalized.
It turned out the pain May was experiencing was far more serious than a pinched nerve and may have been a warning sign of a stroke. But in a woman so young and so fit, who would connect neck pain to a stroke?
"When you're younger and in relatively good health, you think that having a stroke is not a possibility," says David Liebeskind, MD, director of the Neurovascular Programs at Ronald Reagan UCLA Medical Center. The reality is, a stroke can strike at any age, he says.
According to TMZ, doctors told May's family that she suffered a carotid artery dissection. It starts as a tear in the artery wall—which can be caused by an injury like a bad spill—and leads to a blood clot that blocks blood flow to the brain.
While this particular type of stroke is rare, strokes in general are on the rise in younger people, according to the American Heart Association, likely due to health factors like hypertension. Between 1995 and 2008, the hospitalization rate for patients between the ages of 15 and 44 with ischemic stroke (the most common kind) spiked by 37%. A survey by Dr. Liebeskind and his colleagues found that 73% of people under the age of 45 would use the "wait and see" approach if they ever experienced stroke symptoms, rather than rushing to the hospital. That could be a disastrous decision, says Dr. Liebeskind, because the first three hours after symptoms appear is the critical window for treatment.
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So what are the early signs of stroke to look for? Two key clues: A sudden onset of dizziness or severe headache. In an earlier interview with Health, David Newman-Toker, MD, associate professor in the department of neurology at Johns Hopkins University School of Medicine, said those were the most prominent stroke warning signs in women under 45, sometimes accompanied by hiccups or nausea.
Dr. Liebeskind adds a few more early signs of stroke to consider, such as loss of language and changes in vision, strength, or sensation. "If you have a combination [of symptoms], then something's more likely to be off," he says. Other indications: Your symptoms are totally uncharacteristic for you, or they're associated with neck pain, or a recent fall. In those cases, "you have to lean on the side of taking [your symptoms] seriously," says Dr. Liebeskind.
Bottom line: If you're worried, dial 911. And if your ER doc tries to diagnose you with something else, like an inner ear infection or a migraine, don't give up. "Migraine won't kill you, stroke may," points out Dr. Liebeskind.
Dr. Newman-Toker suggests asking the MD this question: "Why do you think it's not a stroke?" "If he can't answer in a way that sounds halfway intelligible, speak to another doctor," he told Health.
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This post was originally published on February 8, 2016 and has been updated for accuracy.