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Ministroke Needs Immediate Attention

Bigger Strokes May Follow, but Many Delay Care for Transient Ischemic Attack
By
WebMD Health News
Reviewed by Louise Chang, MD

March 30, 2006 -- Few people seek immediate medical care for 'ministrokes,' and experts want that to change.

Researchers interviewed 241 people who had been treated in Oxford, England, for a ministroke, or transient ischemic attack (TIA). In a transient ischemic attack, you can have similar symptoms of a stroke, but unlike a stroke, they are temporary and go away. Less than half of the patients -- 44% -- sought medical attention within hours of symptoms.

Delaying care is risky, since bigger strokes may follow TIA, write Matthew Giles, MRCP, and colleagues. They work in the stroke prevention research unit of Oxford University's clinical neurology department.

The study appears in Stroke. Before digging into the data, take a moment to review the warning signs of a transient ischemic attack.

TIA Warning Signs

The American Stroke Association lists these possible TIA symptoms:

  • Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
  • Sudden confusion, trouble with speaking or understanding
  • Sudden trouble with seeing in one or both eyes
  • Sudden trouble with walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

In a transient ischemic attack, blood flow is blocked to the brain for a short time. Symptoms may be brief, but they're still important.

The bottom line: Get medical attention right away for possible signs of transient ischemic attack or bigger strokes.

Delaying Care

The patients in Giles' study were about 71 years old, on average. Those who sought medical help as soon possible were judged to have treated their TIA as an emergency.

The results:

  • 107 patients (44%) responded to their symptoms as an emergency.
  • 27 patients (about 11%) sought medical attention later on the day they noticed symptoms.
  • 43 patients (nearly 18%) delayed getting medical treatment until the next day.
  • 64 patients (almost 27%) waited at least two days to seek medical attention.

When a transient ischemic attack struck on a weekend or holiday, many patients waited until the next business day to seek care.

Patients were more likely to seek immediate medical care if they had longer, more severe symptoms -- such as movement problems -- or were at higher risk of stroke.

Most patients (87%) contacted their doctor, while 10% went to an emergency room.

Awareness Without Action

Less than half of the patients said they realized they were having a transient ischemic attack when the symptoms started. But even those who suspected TIA weren't quicker to seek medical attention.

Almost all of the patients (96%) recalled their first impressions of their symptoms. Of those patients, 42% said they thought they were having a transient ischemic attack. However, knowing TIA's symptoms didn't spur people to quickly seek medical help.

As for the other patients who recalled their initial perception of their symptoms, nearly one in three said they didn't initially know what caused their symptoms. The rest said they suspected stress, eye problems, heart attack, or migraines were to blame.

The study doesn't include people who never sought medical attention for transient ischemic attack.

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