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The major impact of ministrokes

Often referred to as a ministroke , a transient ischemic attack, or TIA, often lasts only minutes, but acts as a warning for a potential full stroke.

Stumble walking across the room? You simply aren’t watching your step. Forget a name or can’t get out the right words? It’s just a fuzzy senior moment. Feeling a little dizzy? You only need to sit down for a second.

While you may dismiss these events as part of normal aging, they also could be subtle, yet serious signs you had a transient ischemic attack, or TIA, also known as a ministroke.

“TIA is like experiencing chest pain, which is often a warning sign for a potential heart attack,” says Dr. Natalia Rost, director of Acute Stroke Services at Harvard-affiliated Massachusetts General Hospital. “TIA is the same. It’s your body’s warning of a possible stroke.”transient ischemic attack

Causes and duration

A TIA occurs when blood flow to the brain gets blocked for a short period. This can occur in several ways. For instance:

  • A blood clot in another part of the body, such as the heart, breaks off, travels to the brain, and blocks a blood vessel in the brain.

  • Smaller blood vessels in the brain become narrow, often because of plaque buildup, which blocks blood flow.

  • Blood flow diminishes at a narrow part of a major artery carrying blood to the brain, such as the carotid artery.

TIA symptoms resemble those of a regular stroke (see “TIA symptoms”), but the difference is their duration. TIA symptoms usually last only one to five minutes, although sometimes they linger up to an hour or longer.

“If you experience symptoms of TIA, even if they last for only a minute, seek out immediate medical care,” says Dr. Rost.

Because TIAs are brief and often don’t cause any obvious physical problems, it’s easy for people to dismiss them. “After a TIA, they are relieved to feel like themselves again, shrug it off, and go about their regular life. But that is when problems may arise,” says Dr. Rost.

For instance, a TIA increases your risk of a regular stroke. Anywhere from 7% to 40% of people who’ve had a TIA will experience a stroke, according to the American Heart Association and the American Stroke Association.

How long before that stroke occurs can vary, from several hours to several months and even a year or longer. However, a majority of strokes after a TIA occur within the initial 48 hours to up to 90 days.

A study published in the April 21, 2016, New England Journal of Medicine estimates the risk of a stroke is 1.5% to 2.1% within the week after a TIA. After 30 days the risk rises to 2.8%, and it reaches 3.7% after 90 days. “The longer underlying problems go untreated, the higher the risk,” says Dr. Rost.

TIA symptoms

  1. Numbness or weakness of the face, arm, or leg, especially on one side of the body

  2. Confusion

  3. Trouble talking or understanding words

  4. Vision problems, including double vision, loss of vision in one eye, or loss of vision on one side of the visual field

  5. Difficulty walking

  6. Dizziness

  7. Loss of balance or coordination

Possible brain injuries

TIA is described as a ministroke, which implies that it is not as serious as a regular stroke. In fact, it was long believed that TIA does not cause any brain injury, but new research has shown this is not true.

Dr. Rost says brain MRIs of people who have had a TIA have found many tiny, dotlike areas of damage (lesions) in the brain, which experts refer to as “white matter disease.” Eventually these lesions can accumulate and lead to serious issues, such as worsening cognition, difficulty walking and performing daily tasks, urinary problems, and even worse outcomes after a stroke occurs.

The problem is that a primary care doctor may not look for possible lesions until a person begins to experience stroke-like symptoms, which is why seeking medical care after a TIA is so crucial.

“The sooner the diagnosis of silent brain injury from TIA-like episodes happens, the sooner treatments and prevention of further damage can begin,” says Dr. Rost.

How to protect yourself

High blood pressure remains the biggest risk factor for both TIA and stroke. “It is essential men get regular check-ups to identify risk factors, and make appropriate diet and lifestyle changes as needed,” says Dr. Rost.

Your doctor also can determine whether you need specific treatments for high blood pressure, high cholesterol, diabetes, or atrial fibrillation, or if you might benefit from aspirin therapy (see “Aspirin therapy: Get it early”), blood thinners, or even surgical procedures—for example, to open narrowed or blocked carotid arteries.

“But making smart choices that support brain and heart health is everyone’s personal responsibility,” adds Dr. Rost. “Moderate alcohol consumption and a diet high in fruits and vegetables, along with daily physical activity like a 30-minute walk, can make a significant difference in the prevention of TIA.”

Aspirin therapy: Get it early

Aspirin therapy may help lower the risk of stroke for people who have had a TIA, according to a study in the May 18, 2016, issue of The Lancet, but the effect is greatest within the initial six-week period after the TIA. Researchers found that aspirin reduced the six-week risk of stroke by about 60% and the risk of a fatal or disabling stroke by 70%. However, the therapy had less effect between six and 12 weeks after the occurrence of a TIA and no benefit after 12 weeks.

Posted by: Dr.Health

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