Mini Strokes Not So MINI!

Mini Strokes Are Not Mini!

If you have a systemic disease like lupus, you’ve heard the word TIA before.  Did you Ever Worry if You Might Have Had a small stroke, also called a tia, transient ischemic attack ?

 TIA occurs when blood flow to a specific part of the brain is temporarily decreased. Even though a TIA occurs in the unseen reaches of the brain, TIA symptoms can be easy to spot. As a general rule, all the symptoms appear suddenly, and often there is more than one TIA symptom present at the same time. Therefore, a TIA can usually be distinguished from other causes of dizziness or headache.  A TIA is serious.  A TIA is a RED FLAG that can save your life!   It is a warning of an impeding stroke.  It is not to be taken lightly.  You may be having a stroke and have only a small window of time to get to the hospital and be treated.  It is not a condition in itself, it is a symptom and sign that you are going to have a stroke.

Is there anyway to tell if you have had a TIA after the symptoms subside?

Yes and No.  Almost always, the symptoms and signs of a TIA will have gone away by the time you get to the hospital. A TIA diagnosis may be made based on your medical history alone.  There are tests that can be done to determine why and if you had a tia episode or stroke.  EARLY INTERVENTION of a TIA OR STROKE in a hospital CAN and DOES SAVE LIVES!  Call 911 without delay!!!!

Exams and Tests

The health care provider will do a complete physical exam to check for heart and blood vessel problems, as well as for problems with nerves and muscles.

Your blood pressure may be high. The doctor will use a stethoscope to listen to your heart and arteries. An abnormal sound called a bruit may be heard when listening to the carotid artery in the neck or other artery. A bruit is caused by irregular blood flow.

Tests will be done to rule out a stroke or other disorders that may cause the symptoms.

•             You will almost always have a head CT scan or brain MRI. A stroke will show changes on these tests, but TIAs will not.

•             You will have an angiogram, CT angiogram, or MR angiogram to see which blood vessel is blocked or bleeding.

•             You may have an echocardiogram if your doctor thinks you may have a blood clot from the heart.

•             Carotid duplex (ultrasound) can show if the carotid arteries in your neck have narrowed.

•             You may have EKG and heart rhythm monitoring tests to check for irregular heartbeat.

Your doctor may do other tests to check high blood pressure, heart disease, diabetes, high cholesterol, and other causes of and risk factors for TIAs or stroke.  Your doctor may use these tests to check for hypertension, heart disease, diabetes, high blood lipids, vasculitis, and peripheral vascular disease.

Other Tests to diagnose a TIA may include:
* CBC and PT tests to rule out a blood disorder
* Head CT scan or cranial MRI
* Carotid duplex (ultrasound)
* Echocardiogram
* Cerebral arteriogram
Additional tests and procedures may include:
* Blood glucose
* Blood chemistry
* Serum lipids
* ESR (Sedimentation rate)
* Tests for syphilis
* ECG
* Chest x-ray

Specific TIA Symptoms

For a person having a TIA, the symptoms will vary depending on which part of the brain is affected.

 Examples of specific symptoms include:

•             Sudden numbness or weakness of face, arm, hand, or leg, especially on one side of the body

•             Sudden confusion

•             Trouble speaking or understanding speech

•             Sudden trouble seeing in one or both eyes (such as double vision, blurred vision, or blindness)

•             Sudden trouble walking, dizziness or lightheadedness

•             Sudden loss of balance or coordination

•             Sudden severe headache with no known cause

•             Vomiting

•             Loss of consciousness

•             Spinning sensation (vertigo)

•             Sudden collapse

•             Seizures (in a small number of cases).

If you suspect you or someone you know is experiencing one or more of these TIA symptoms, do not wait for the symptoms to worsen or improve. Call 911 immediately. It is impossible for you to know whether these are symptoms of a TIA or signs of something more serious, such as a stroke.

A TIA is different than a stroke. After a TIA, the blockage breaks up quickly and dissolves. Unlike a stroke, a TIA does not cause brain tissue to die.

The loss of blood flow to an area of the brain can be caused by:

•             A blood clot in an artery of the brain

•             A blood clot that travels to the brain from somewhere else in the body (for example, from the heart)

•             An injury to blood vessels

•             Narrowing of a blood vessel in the brain or leading to the brain

High blood pressure is the number one risk for TIAs and stroke. The other major risk factors are:

•             Atrial fibrillation

•             Diabetes

•             Family history of stroke

•             High cholesterol

•             Increasing age, especially after age 55

•             Race (African Americans are more likely to die from stroke)

People who have heart disease or poor blood flow in their legs caused by narrowed arteries are also more likely to have a TIA or stroke.

Treatment

The goal is to prevent a stroke.

If you have had a TIA within the last 48 hours, you will likely be admitted to the hospital so that doctors can search for the cause and observe you.

High blood pressure, heart disease, diabetes, and blood disorders should be treated as needed.

You may receive blood thinners, such as aspirin, to reduce blood clotting. Other options include dipyridamole, clopidogrel, Aggrenox or heparin, Coumadin, or similar medications. You may be treated for a long period of time.

Some people who have clogged neck arteries may need surgery (carotid endarterectomy).

Outlook (Prognosis)

TIAs do not cause lasting damage to the brain.

However, they are a warning sign that you may have a true stroke someday. More than 10% of people who have a TIA will have a stroke within 3 months. Half of these strokes happen during the 48 hours after a TIA. The stroke may occur that same day or at a later time. Some people have only a single episode, and some have more than one episode.

You can reduce your chances of a future stroke by following-up with your health care provider to manage your risk factors.

When to Contact a Medical Professional

A TIA is a medical emergency. Call 911 or another local emergency number right away. Do not ignore symptoms just because they go away. They may be a warning of a future stroke.

When to Contact a Medical Professional

A TIA is a medical emergency. Call 911 or another local emergency number right away. Do not ignore symptoms just because they go away. They may be a warning of a future stroke.