Ministroke: Quick Care Pays Off
Transient Ischemic Attack and Minor Stroke Deserve Immediate Care, Experts Say
Oct. 8, 2007 -- When a "ministroke" strikes, immediate medical care
may help prevent a bigger stroke.
That's the take-home message from two new studies published in tomorrow's
edition of The Lancet.
A quick review: Stroke can be caused by a blood clot (ischemic stroke) or
bleeding in the brain (hemorrhagic stroke).
Transient ischemic attacks (TIAs) can precede ischemic strokes. In a TIA,
stroke symptoms flare up and quickly fade. TIAs technically aren't strokes, but
they're often called "ministrokes."
Stroke symptoms can include:
- Sudden weakness or numbness in the face, arm, or leg on one side of the
- Abrupt loss of vision, strength, coordination, sensation, speech or the
ability to understand speech. These symptoms may become more marked over
- Sudden dimness of vision, especially in one eye.
- Sudden loss of balance, possibly accompanied by vomiting, nausea, fever,
hiccups, or trouble with swallowing.
- Sudden and severe headache with no other cause followed rapidly by loss of
consciousness -- indications of a stroke due to bleeding.
- Brief loss of consciousness. Unexplained dizziness or sudden falls.
Seek emergency medical care at the first sign of those symptoms. The stakes
are too high not to take action, even if the symptoms disappear quickly.
British Stroke Study
The two new stroke studies show benefits from quick care for stroke or minor
One of the two new stroke studies comes from Oxford, England.
At the study's start, TIA or minor stroke patients needed a doctor's
referral to go to a special stroke clinic. Later, the referral requirement was
When patients didn't need a referral, they came to the clinic sooner.
As a result, those patients were 80% less likely to have a stroke within
three months of their TIA or minor stroke, compared with those treated when the
referrals were required.
French Stroke Study
The second study comes from Paris, where stroke experts set up a 24-hour TIA
clinic and publicized the clinic with local doctors.
Some 700 patients with confirmed TIA or minor stroke came to the clinic
within 24 hours of the start of their symptoms.
As a result, they were less likely to have a stroke in the next three
months, according to Philippa Lavallee, MD, and colleagues.
Lavallee works for the Department of Neurology and Stroke Centre at the
Denis Diderot University and Medical School in Paris.
TIAs and minor strokes warrant urgent care, write editorialists in The
"Rapid assessment and intervention is emerging as the new standard for
TIA care," write the editorialists, who included Water Kernan, MD, of Yale
University's medical school.