Is "Mini-Stroke" a Misleading Term?

Contributed by: Dennis Fortier, President, Medical Care Corporation

As our population simultaneously ages and becomes more obese, poor cardiovascular health has driven the incidence of certain medical conditions ever higher.  For example, general awareness and acceptance of transient ischemic attacks, alternatively known as TIA's and mini-strokes, has risen notably over the past two decades.

While awareness of medical conditions and the risks that cause them is generally a good thing,  a false comfort, based on a perception of "good medical outcomes", can be quite dangerous.

Sticking with the example of TIA's, the tone of much public discourse on such a clear symptom of severe cardiovascular disease, has been somewhat benign.  Because "mini-strokes" are common, and immediate outcomes are often fairly good, we may be developing a false notion that a mini-stroke is a minor occurrence.  On the contrary, a mini-stroke is a serious sign that immediate, medical attention is needed.

A recent study published in the journal Stroke showed that lingering disabilities, following a mini-stroke, are highly prevalent.  In fact, about 15% of patients who had a single TIA had lingering disabilities after three months and, for those who had a series of TIA's, more than half (53%) had lingering disabilities.

More importantly, TIA's are a major warning sign of an underlying problem that could lead to a much bigger stroke and major debilitation of the brain.  While the symptoms of a small stroke may fade quickly, immediate medical attention is still required.  Ignoring such events could lead to dire consequences including death.

The term "Mini-Stroke" may connote an insignificant event, but the evidence suggests that any stroke is serious, and the concept of "mini" might be misleading in terms of its health-related consequences. 

What is a Transient Ischemic Attack?

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Transient ischemic attacks are common.   They are known as TIA's or mini-strokes, and they produce temporary symptoms of numbness, tingling, and sometimes, weakness or difficulty speaking.  They are caused by a temporary lack of blood flow to the brain and, as the term "transient" suggests, they have generally been considered to be temporary events, with no lasting effect.

According to a recent publication in Stroke, the journal of the American Heart Association,  these events may not be as transient as previously believed. Researchers from the University of British Columbia performed transcranial magnetic stimulation (TMS) on subjects who had suffered a recent TIA and found interesting results.  These subjects' brain cells were more difficult to stimulate, as is necessary in learning and recalling information, than the brain cells in subjects with healthy brains. 

TIA's have long been considered a warning sign that more serious, future strokes could be more likely.  But this new information suggests that they are more than a warning sign of future problems; they might be a part of a current problem with long-term effects on brain health.

For perspective, this was a small study involving only 13 subjects, and the results have not yet been reproduced in other peer-reviewed publications.  It is merely the first step, and perhaps an important one, in the scientific process by which we discover and validate new knowledge.

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Many Strokes Preceded by a "Warning"

Contributed by: Dennis Fortier, President, Medical Care Corporation
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According to a recent publication in Neurology, about one in eight strokes is preceded by a transient ischemic attack, known as a TIA, which is very mild stroke that usually produces only subtle and short lasting symptoms. The research suggests that noting and reacting to this warning can reduce the likelihood of a more serious stroke later.

Th importance of this study is highlighted by the fact that up to 80% of strokes that follow a TIA might be preventable with intensive management of risk factors. Risk factors that should be managed include hypertension, high cholesterol, smoking, diabetes, and obesity. Also important is expert evaluation (and intervention if necessary) following any symptoms of stroke, even mild symptoms from a TIA.

Please consider sharing this short posting (share button below) with any of your contacts who may be at risk for stroke.