Most of us will schedule a visit to the doctor if we’re having pain or just feel like something’s wrong.
And often, if those symptoms go away before our visit, we happily cancel and go about our business.
However, in the case of a mini-stroke—also known as a transient ischemic attack or TIA—that is absolutely the worst thing you can do, said Dr. Jeff Switzer, a neurologist with Augusta University Health.
In many ways, a mini-stroke sounds like the less harmful brother to an actual stroke. It has the exact same symptoms as a stroke, including:
- Face drooping
- Weakness or numbness on one side of the body
- Speech problems, such as slurred speech or not being to speak
- Trouble walking
- Dizziness or confusion
But here’s the tricky part: Those symptoms may last only minutes or up to a few hours, and then you seem totally fine—compared to a stroke, where the symptoms linger until you get help.
“Although patients may be a little alarmed to experience numbness or weakness, sometimes they wait to see how bad it is. When it goes away, they may have false reassurance from that,” said Switzer.
Why Mini-Strokes Are Important
Studies have shown that up to 20 percent of people who have experienced a mini-stroke will go on to have a stroke in the next 90 days. But what’s most concerning is that about half of those will go on to have a stroke within just a few days. “The risk of stroke is highest in the hours or days after a mini-stroke, so anyone who has experienced these symptoms needs to be evaluated right away,” said Switzer.
Mini-strokes happen because blood flow to the brain was blocked for a short period of time. Just because the flow was restored and symptoms go away doesn’t mean the underlying problem was fixed.
Think You Had a Mini-Stroke? Go to the ER
The best advice for anyone experiencing the symptoms of a stroke is to go immediately to the ER. Even if it turns out to be a mini-stroke, you’ll need to be evaluated to see what caused your symptoms. And if you are experiencing an actual stroke, there’s only a three-hour window—beginning when symptoms start—where doctors can prescribe the clot-busting drug tPA, which is effective in many cases to help prevent long-lasting disability from stroke.
When you go to the ER, you can expect to have imaging done, either a CT scan or more commonly an MRI. The scan will examine the brain as well as the blood vessels in the head to look for blockages or narrowed arteries and to rule out bleeding in the brain or even a brain tumor. An ultrasound of the carotid arteries in the neck should also be done to look for blockages that could lead to a stroke. Doctors will also examine the heart using an electrocardiogram (EKG) or echocardiogram (also known as a heart ultrasound) to check if a clot may have traveled from the heart up to the blood vessels in the brain.
The great news is that in most cases surgery is not needed to help fix the problem. Physicians will typically prescribe medicines such as aspirin or other blood thinners, statins to reduce cholesterol and possibly blood pressure medications. Making changes to your lifestyle—such as quitting smoking, adding in some exercise and switching to the Mediterranean diet—have all been found to be extremely helpful in dropping that risk of a follow-up stroke.
But here’s the reason physicians want anyone with symptoms of stroke or mini-stroke to head directly to the ER: A small percentage of patients may have a high-grade carotid stenosis—a narrowing in one of the arteries that supply blood to the brain—which will need immediate, urgent surgery. “We try to ideally have a surgery performed or have a stent placed within a week or so of a mini-stroke since these patients do have such a high risk for a follow-up stroke,” said Switzer.
So think of a mini-stroke as a warning—and make sure to listen. “We always say, ‘Don’t wait. Go straight to the ER,” said Switzer. “Whether it’s a stroke or a mini-stroke, you need to be seen right away.”