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Heed the warning signs of a mini-stroke

Heed the warning signs of a mini-stroke

What does it mean when your arm suddenly goes numb for no apparent reason, but the feeling returns in a few minutes? Or when you suddenly can't see or speak properly for an hour, but then everything returns to normal?

It could mean you have just had a "transient ischemic attack" (TIA), or mini-stroke.

Sudden numbness or weakness of the face, arm, or leg; sudden confusion; trouble speaking or understanding; trouble seeing in one or both eyes; dizziness; trouble walking, and loss of balance or coordination may be symptoms of a stroke. One or more of these or other symptoms can also occur in a mini-stroke, but are temporary and do not destroy brain cells.

Still, stroke experts say, it's important to be checked by a doctor immediately.

"A TIA is a warning sign," says Dr. Philip Gorelick, professor emeritus, Department of Neurology and Rehabilitation and past director of stroke research for the University of Illinois-Chicago College of Medicine, and medical director, Mercy Health Hauenstein Neurosciences in Grand Rapids, Mich.

In fact, about one in four people who have one TIA will have another TIA, a full-blown stroke or heart problem, or die within the next few months.

Diagnosing a mini-stroke

A study that followed 1,000 patients in California who went to the emergency room with a TIA found 10.5 percent went on to have a full-blown stroke within 90 days. Half of these strokes occurred within two days of the TIA.

"That's a stunning message to everybody about the need for speed," Gorelick says. "If we respond rapidly to diagnose these (TIA) patients, these strokes are preventable."

It is clear that medical attention can decrease your risk of post-TIA complications and significantly reduce the risk of a future stroke and other complications. Distressingly, the National Stroke Association says that about half of people who experience TIA symptoms don't report it to their doctors, so they do not receive appropriate post-stroke care.

To determine which TIA patient will be most likely to suffer future stroke symptoms, doctors use a scale known as ABCD2. The A stands for age (patients age 60 and older are at greater risk); B stands for blood pressure higher than 140 over 90; C stands for clinical symptoms such as localized weakness or altered speech, and D2 stands for a history of diabetes and the duration of symptoms.

Depending on your score, you may need to be admitted to the hospital to receive treatment, even – and this is important – if your symptoms have already resolved.

Causes, treatment of TIA

A TIA or stroke occurs when the blood flow to the brain is blocked. In a TIA, however, the blood flow returns before the brain is damaged. According to the National Stroke Association, the three most common causes of blockages are:

  • Low blood flow at a narrow part of a major artery responsible for carrying blood to the brain, such as the carotid artery. This can result from plaque build-up in the artery, similar to blockage in arteries in the heart that can lead to a heart attack.
  • A blood clot in another part of the body that breaks off and travels to the brain. For example, people with certain heart conditions or irregular rhythms such as untreated atrial fibrillation can develop clots in the heart which can break off and travel to the brain.
  • The narrowing of a smaller blood vessel in the brain due to hypertension.

Treatments for TIAs and stroke include medications to lower blood pressure, prevent blood clots, treat heart disease, or lower cholesterol. Surgery might be necessary if, for example, blockage of the carotid artery is responsible.

But experts agree that your best move is acting quickly if you are experiencing stroke-like symptoms. Call 9-1-1 or go to the emergency room for diagnosis and treatment.

For more on ways to prevent strokes, view Risk factors for stroke, and FAST: Know the signs of a stroke.