The term “mini stroke” is as its name implies – it does not last as long as a full stroke does, at times only taking place for a few short minutes. However, a mini stroke, or transient ischemic attack (TIA) as it is known in the medical field, can be just as worrisome.
A mini stroke, according to the American Heart Association, is essentially a “warning stroke,” informing you to take heed of your health. Indeed, an estimated 500,000 people in the US alone experience a mini stroke episode each year.
Dr. Emil Matarese, director of a primary stroke center at St. Mary’s Medical Center in Pennsylvania says, “TIA is a warning stroke and gives a patient time to act and keep a permanent stroke from occurring.” An incident of TIA is fundamentally as much an emergency as a full stroke is; consequently, the same response protocol for a full stroke should likewise be applied to a case of TIA.
A person who has a mini stroke, after all, is at greater risk for having a full stroke sometime in the future. Statistically, up to 15% of those who experience a mini stroke end up having a full stroke within three months, and 40% of those in this group experience the full stroke within 24 hours. Because of this increased risk, it is vital to know what the symptoms of a mini stroke are so that help can be immediately sought. Evaluation and treatment of those with a mini stroke minimizes the risk of a subsequent acute stroke.
Once a person has experienced TIA, it is important to seek medical attention immediately. A number of tests will be administered to identify the underlying factors that caused the TIA. These tests include blood tests, a chest X-ray, electrocardiogram (ECG), echocardiogram, an MRI scan, a computerized tomography (CT) scan, as well as an ultrasound.
But what is it exactly? A mini stroke temporarily interrupts the blood flow (and thereby the oxygen supply) to the brain. The two main blood vessels that supply blood to the brain, the carotid arteries, branch off into smaller and even smaller vessels (capillaries). During a mini stroke, one of these smaller blood vessels becomes briefly blocked, so the affected part of the brain is deprived of oxygen.
There are three determinants of blockage: atherosclerosis, blood clot, and hemorrhage. In the first case, the blockage is caused by either a narrowing of the arteries (stenosis) from atherosclerosis, when fatty deposits (plaque) develop within the inner lining of blood vessels so that they harden and thicken, thus losing the flexibility required for proper blood flow. Blood clots, meanwhile, stem from heart conditions (e.g. congestive heart muscle disease, or irregular beating of the heart as in atrial fibrillation), blood conditions (e.g. very thick blood as in polycythemia, high blood fat levels as in hyperlipidemia, overproduction of blood platelets as in thrombocyemia, sickle cell anemia), and infections (phlebitis). There’s also cases of when an embolism – blood clot from another part of the body – dislodges and travels up to the brain and hinders blood flow in the vessels supplying the brain. Lastly, the third cause is deemed rare and involves hemorrhage, which is when internal bleeding occurs in the brain.
At any rate, during a mini stroke, disruption of oxygen-rich blood to the brain can be as brief as a minute, or even last for a few hours, but typically a mini stroke occurs for about 5 – 10 minutes. If signs persist for more than 24 hours, then brain cells die and cause permanently debilitating damage – this is when it is considered a full stroke. Do not wait 24 hours to find out! Seek medical help immediately because a mini stroke can be a prelude to a full stroke, which, in turn, leads to more serious and permanent damage. This is especially true for those in high risk groups, such as those with diabetes, those having high blood pressure (hypertension), and those who are elderly.
How can one recognize it? If you are the person experiencing, or observing as a bystander, any of the following signs, then a mini stroke is more than likely taking place:
• A very bad headache that occurs suddenly with no known cause
• Dizziness or vertigo
• Weakness, numbness, or paralysis on one side of the body
• Clumsiness of hands and fingers
• Difficulty swallowing
• Difficulty understanding what others are saying
• Sudden confusion
• Sudden inability to walk or stand, lack of coordination and balance (e.g. falling down, or even gait disturbance)
• Sudden inability to speak (e.g. slurred or garbled speech)
• Sudden inability to write, text, or communicate (e.g. gibberish)
• Change in eye function (e.g. loss of vision in one or both eyes, or double vision)
• Amnesia
• Loss of consciousness
Another helpful reminder is the acronym “F.A.S.T.” – for it can assist in gauging symptoms of a mini stroke:
– F stands for Face drooping (e.g. facial muscles paralyzed, unable to smile properly)
– A stands for Arm weakness or numbness
– S stands for Speech impairment (e.g. garbled, slurring)
– T stands for Time to call 911 (or 999 in the United Kingdom)
The acronym “F.A.S.T.” was so-coined because it emphasized the urgency of the situation and is essentially a call to quick action. The faster 911 is contacted and health officials notified, then the more rapidly medical attention can arrive. This is crucial for quick recovery. Moreover, it alerts medical officials that appropriate steps have to be taken to prevent the more serious full stroke from occurring in the future.
There are risk factors leading to mini stroke, and some of them can be changed, while others cannot. Those risk factors that cannot be altered include ethnic origin, gender, age, and family history. Those of African extraction have a higher risk of stroke and TIA. Males have higher risk than females. Those aged 55 and older have increased risk of TIA. And, those with a family history of TIA or stroke are more likely to experience it themselves.
As for those risk factors that can be altered to minimize the risk of a mini stroke and full stroke, they include: bad diet, sedentary lifestyle, body weight, blood cholesterol levels, high blood pressure (hypertension), diabetes, homocysteine levels (homocysteine is an amino acid produced by one’s body as a byproduct of consuming meat), cardiovascular disease, carotid artery disease, peripheral artery disease, alcohol, smoking, and illegal substance use. In other words, eliminating the bad habits of smoking, drinking, and illegal substance use will minimize the risk of strokes and TIA. So, too, will adjusting one’s diet (e.g. shift to low sodium intake and reduce red meat consumption) as well as ramping up one’s physical exercise regimen. Additionally, following your physician’s guidelines in the care of any other maladies you might have can likewise go a long way in preventing a stroke or TIA from happening. Finally, drinking more water and making sure to have a good quality sleep of at least 7 hours every day is highly advised.
It must be emphasized that even though a mini stroke might resolve itself on its own, the sufferer should nonetheless seek medical attention, preferably within the first hour after experiencing symptoms. This is because the earlier he or she is seen, the better the potential outcome and the lower the risk of complications. A physician can help you take the necessary steps to prevent a future full stroke, manage your health after TIA, and accordingly stay on the road to good health. TIA should not be ignored nor taken lightly.
For more information on your health concerns about TIA, try the websites of Johns Hopkins Medicine and of Stanford Medicine.