Mini stroke

Q: I have an officemate who was rushed to the hospital a few days ago because he had a mini stroke. He is ok now and is back to work. What is a mini stroke, how does it differ from a real stroke? -Joe V., Mandaluyong City


A: Mini stroke is layman’s term for transient ischemic attack (TIA). The signs and symptoms of TIA are like those of a stroke, but in TIA the neurologic impairments are temporary—often lasting only a few minutes to two hours, rarely, up to a day.

TIA and stroke do not only have the signs and symptoms, they also have the same immediate cause—a disruption of the blood supply to an area of the brain. In TIA, however, the disruption is transitory and brief. Hence, unlike stroke, a TIA does not lead to permanent brain damage. Likewise, TIAs also do not show changes to the brain on CT or MRI scans. Incidentally, the underlying causes of TIAs are likewise the same as those of stroke.

A TIA is considered by experts as a warning sign that a stroke is going to occur that same day or at a later time. About five percent of people who have a TIA develop a stroke within 48 hours of the TIA and another five percent within three months. However, not all TIAs lead to a stroke, neither are all strokes preceded by a TIA.

In as much as a TIA can in fact herald an impending stroke, TIA symptoms should never be ignored. If a person is showing signs of TIA, bring him to a hospital.

The signs and symptoms of TIA (or a stroke for that matter) vary depending on the location and, to a certain extent, the size of the involved area of the brain. Its more common manifestations include numbness, weakness or paralysis—often, one-sided—of the face, arms or legs; headache that may be accompanied by vomiting; blurring of vision; loss of balance and coordination resulting in disturbances in gait; slurring of speech; inability to understand; and, impairment of consciousness.(e.g., confusion, disorientation, incoherence, coma).

In TIAs, the goal of treatment is to prevent a stroke from occurring either in the immediate or distant future. People with TIAs need to be initially admitted, observed and examined in the hospital to determine the underlying cause of the condition, which could be high blood pressure, heart disease, diabetes, and blood disorders. The underlying cause will have to be treated. Likewise, blood thinners such as aspirin, dipyridamole and clopidogrel may have to be taken in maintenance doses. Rarely, surgery may have to be performed on people who have severely clogged neck arteries.

The risk factors for TIAs and stroke include hypertension, high blood cholesterol level, diabetes mellitus, smoking, cardiac disease, drug abuse, heavy alcohol consumption, family history of the disease, and intake of certain drugs (e.g., anticoagulants, cocaine and amphetamines).

Thus, people who have experienced a TIA (and normal people, for that matter) can reduce their odds of having a stroke in the future by adopting lifestyle changes aimed at eliminating the risk factors for stroke:

• Quit smoking.

• Stick to a low-salt, low-fat, high fiber diet.

• Indulge in a regular exercise program.

• Maintain a desirable body weight through proper diet and exercise.

• Drink alcohol moderately—no more than two drinks a day. Better still, don’t drink at all.

• Avoid stress. If you can’t, learn to relax through exercise, sports, listening to music, etc.

• Refrain from taking illegal drugs.

• If you have hypertension and/or diabetes, these chronic conditions must be under supervision of a physician.