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Mini strokeSaturday 6 July 2013 00:01 CEST
In nearly 50 percent of cases the body is warning us of an impending danger - like earthquakes usually precede the eruption of a volcano. Mini stroke is a sign that another one may follow and further attacks may have more serious consequences or develop into a full stroke.
A transient ischaemic attack (TIA) happens when part of the brain is temporary cut off of the blood supply. Symptoms are similar to those of a stroke and that's why TIA is also known as mini stroke.
The disruption in one of the small blood vessels that supply the brain with oxygen-rich blood results in a lack of oxygen and that can cause speech problems, visual disturbance, numbness, and weakness in the arms and legs. A transient ischaemic attack doesn't last as long a stroke, just for a few minutes and after 24 hours everything is usually back in normal.
Just in the U.S. there are 200,000 to 500,000 transient ischaemic attacks every year but those are just reported cases because many people get well fast and never mention it to their doctors. TIA may happen in every age, but persons aged 60 years or older are in a greater danger.
How to recognize TIA symptoms fast? Well, with F.A.S.T. This is short for Face-Arms-Speech-Time and it's a simple diagnostic tool. The face may fall on one side or the patient is unable to smile, the patient may not be able to raise both arms and keep them up, the patient may have slurred speech, and time - if any of these symptoms is present, it is time to visit the doctor immediately.
Now, if those symptoms last longer than 24 hours, then we are not talking about mini stroke, we are talking about a full stroke. However, if the patient can't get to the doctor during the first 24 hours and he recovers with no outside help, it is recommended that he still see the doctor: some 30 percent of patients who experience a transient ischaemic attack will have a stroke within a year. We can say that TIA is a warning and it gives a patient time to prevent a full stroke.
It is important to know some factors that contribute to TIA; persons with them should pay close attention if any of symptoms occur. Especially alert should be anyone with hypertension, cardiac disease, diabetes mellitus, people with high levels of cholesterol in the blood, smokers, obese people, excessive alcohol drinkers and people who already had TIA.
What causes blood vessels to be blocked? Atherosclerosis is a suspect number one: fatty deposits are developing in patient's blood vessels, they become thickened and it's more difficult for blood to flow freely. A blood clot as a result of some other health condition can also block small blood vessels and cause mini stroke. There is a possibility, although that happens in a small number of cases, that a small bleeding in the brain can cause TIA.
What the doctor can do? The treatment depends on every individual case. Sometimes just a simple change in lifestyle can help: regular exercise, leaving cigarettes away and limiting alcohol consumption can help some patients without any further medical treatment. Some patients will get drugs and some need a surgery.
The doctor can use anti-platelet drugs which make platelets, blood cell types, less likely to stick together. Anticoagulants are also used and they affect clotting-system proteins to make cloth creation harder. If the patient's neck artery is narrowed the doctor will open the artery and remove the plaques, thus preventing further narrowing or flowing of small cloths around the blood system.
Abraham Eisenstein, MD