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There’s nothing small about a mini-stroke

Neurology
Dec 11, 2019

St. Joseph’s/Candler Neurohospitalist Dr. Matthew Marshall explains Transient Ischemic Attack

Don’t let the term “mini” in mini-stroke fool you. It’s actual a major event and should not be ignored. 

Often called a mini-stroke, the medical term is Transient Ischemic Attack (TIA) and is defined as an abrupt temporary blockage of blood flow to the brain. It results in common stroke symptoms which resolve within minutes to hours. 

Because TIAs are short and do not cause lasting damage, people often do not seek medical attention, but it’s still important to treat them like an emergency and get care right away.

Dr. Matthew Marshall

About 240,000 Americans experience a TIA every year, according to the American Stroke Association. TIAs are often followed by strokes. In fact, about one in three people who have a TIA go on to have a more severe stroke, with about half occurring within one year. 

“Any transient stroke-like syndrome should not be dismissed as a ‘near miss’ but be investigated as aggressively as a stroke would,” says Dr. Matthew Marshall, neurohospitalist with St. Joseph’s/Candler. 

Symptoms

It begins with recognizing the symptoms of TIA, regardless of how short or long they last. Symptoms of TIA would be the same as a stroke, Dr. Marshall says, which requires you to think F.A.S.T.

  • F – Facial droop; check if one side of the person’s face droops down
  • A – Arm weakness or numbness
  • S – Speech changes; check for slurred speech or inability to speak
  • T – Time to call 9-1-1; get the person to a hospital as soon as possible

Related Article: What are the signs of a stroke?

 

Other signs of TIA include:

 

  • Dizziness
  • Gait instability
  • Confusion
  • Visual changes
  • Difficulty swallowing
  • New sensory disturbances

Diagnosing and treating TIAs

If you or anyone you know experience any of these symptoms it’s important to seek medical attention immediately. Strokes are treatable and getting fast treatment is important in preventing another major event, disability or even death.

Healthcare professionals have diagnostic tests and tools to determine if a patient experienced a TIA or more severe type of stroke. One such test is called an ABCD2 score. It looks at metrics that include age, blood pressure upon presentation of symptoms, clinical features, duration of symptoms and the presence or absence of diabetes, Dr. Marshall says. 

“Based on the score given, the risk for a two-day, seven-day and 90-day stroke-risk can be calculated and the need for emergent hospitalization can be made.”

Advancements in imaging technology, particularly MRIs, also help distinguish TIA vs. stroke. Stroke-like symptoms lasting for an entire day should be evident on an MRI, Dr. Marshall says. Conversely, if the blockage was very small, an MRI may not reflect a stroke-like event despite a patient presenting with TIA symptoms. 

Related Article: What to expect during MRI

Ongoing symptoms in the emergency department may make the patient a candidate for treatment options that can include intravenous tPA (a clot-busting drug), depending on the ultimate diagnosis – TIA or stroke. 

Related Article: Rehabilitation after a stroke can help with symptoms, improve quality of life

Risk Factors and Prevention

Knowing your risk factors and living a healthy lifestyle are the best things you can do to prevent a TIA. Some risk factors for TIA you can control while others you can’t. Common risk factors include:

  • Family history
  • Age; your risk increases as you get older, especially after age 55
  • Sex; men have a lightly higher likelihood of a TIA and stroke,  but more than half of deaths from strokes occur in women
  • Race; African-Americans are at a greater risk of dying of a stroke
  • High blood pressure
  • High cholesterol 
  • Cardiovascular disease, which includes heart failure, a heart defect, a heart infection or an abnormal heart rhythm 
  • Carotid artery disease or peripheral artery disease
  • Diabetes
  • Excess weight
  • Cigarette smoking
  • Excessive alcohol use

By knowing these risk factors, controlling the ones you can and living a healthy lifestyle – don’t smoke, exercise regular, limit alcohol intake and eat lots of fruits and vegetables – you can lower your risk of a stroke.

And while a TIA serves as a warning sign of a future stroke, it also can be an opportunity to take steps to try to prevent it. 

Related Article: How preventable is a stroke?

St. Joseph’s/Candler’s commitment to treating TIAs, strokes

St. Joseph’s/Candler is one of a handful of hospitals in the country to achieve the designation as a Primary Stroke Center, awarded by The Joint Commission. We are committed to reducing the number of deaths and permanent disabilities caused by stroke. A stroke team is available 24 hours a day and consists of emergency physicians, neurologists, neurosurgeons, neuroradiologists, neurohospitalists, nurses, therapists and paramedics. 

Included in the Stroke Program is the Stroke NET-work. St. Joseph’s/Candler has invested in new technology called REACH Call that allows board-certified neurologists to diagnose and treat TIA and stroke patients in rural hospitals through telemedicine. 

To learn more about our Stroke Program and the Stroke NET-work, visit our website.


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