The Early Signs of Stroke You Need to Know—Even If You’re Young

— -- In a very sad and shocking turn of events, social media star and model Katie May died last week after suffering a stroke. The New York Daily News reported that May, 34, 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 turns out the pain May was experiencing was far more serious than a pinched nerve. 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.

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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, likely due to health factors like hypertension. Between 1995 and 2008, the hospitalization rate for stroke patients between the ages of 15 and 44 spiked by 37 percent. What’s more upsetting, a new survey by Dr. Liebeskind and his colleagues found that 73 percent 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 warning signs 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 symptoms in women under 45, sometimes accompanied by hiccups or nausea.

Dr. Liebeskind adds a few more signs to consider, such as loss of language, 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.

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Bottom line: If you’re worried, dial 9-1-1. 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.

This article originally appeared in Health.com