Beyond Symptom Recognition: Stroke Knowledge and Understanding of Its Neuroanatomical Mechanism Among University Students

Abstract

Background: Stroke is a leading cause of death and disability worldwide, and prompt recognition of its warning signs depends on adequate public and student knowledge of its risk factors, symptoms, and underlying neuroanatomical mechanism. Data on how well health-science students understand not only the clinical presentation but also the pathophysiological basis of stroke remain limited. Methods: A cross-sectional survey of 83 university students (74.7% male, 96.4% from health-related disciplines) was conducted using a structured, self-administered online questionnaire covering demographics, general stroke awareness, warning signs, risk factors, and an open-ended item on the neuroanatomical mechanism of stroke. A 30-item knowledge scale (General Awareness, Warning Signs, Risk Factors) was scored against a factual answer key, and total scores were categorized as Poor (<60%), Moderate (60–79%), or Good (≥80%). The open-ended neuroanatomy response was independently coded for conceptual accuracy. Group comparisons used independent t-tests, one-way ANOVA, and chi-square tests (α = 0.05). Results: Mean total knowledge score was 63.4% (SD = 20.3 percentage points; 19.02/30 items; Cronbach's α = 0.87). Only 26.5% of respondents were classified as having Good knowledge, 41.0% Moderate, and 32.5% Poor. General awareness (69.4%) exceeded warning-sign (61.7%) and risk-factor (62.6%) recognition. Common misconceptions included believing stroke affects only the elderly (38.6%) and equating stroke with heart attack (24.1%); more than half of respondents misclassified non-stroke distractor items (skin itching, gradual weight gain, arm-radiating chest pain) as stroke warning signs. Only 12.0% of respondents could correctly explain the neuroanatomical mechanism of stroke (interrupted blood/oxygen supply leading to neuronal death), and this conceptual understanding was not associated with the factual knowledge score (F = 0.24, p = 0.867). No demographic or academic variable was significantly associated with total knowledge (all p > 0.05), though a non-significant downward trend was observed with increasing level of study (p = 0.076). Conclusion: Despite a health-science-dominated sample, overall stroke knowledge was only moderate, and understanding of the underlying neuroanatomical mechanism was markedly deficient relative to factual/recognition knowledge. Curricula should place greater emphasis on the pathophysiological basis of stroke, not solely on symptom and risk-factor checklists.