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What is a ministroke or TIA?
A ministroke is also known as a transient ischemic attack (TIA). It occurs when part of the brain experiences a temporary lack of blood flow. This causes stroke-like symptoms that resolve within 24 hours.
Unlike a stroke, a ministroke on its own doesn’t cause permanent disabilities. Since ministroke symptoms and stroke symptoms are nearly identical, you should seek immediate emergency attention if you experience any symptoms.
Knowing the signs of a ministroke can help you get the treatment you need as early as possible. Around 1 in 3 people who experience a ministroke later experience a stroke, so early treatment is essential.
A ministroke can be difficult to identify, but a few symptoms may indicate that you’ve had one. The symptoms may be fleeting.
The most common symptoms of a ministroke are:
- dysphasia, a language disorder
- dysarthria, or physical difficulty when speaking
- vision changes
- balance issues
- an altered level of consciousness
- passing out
- severe headache
- an abnormal sense of taste
- an abnormal sense of smell
- weakness or numbness on just the right or left side of the face or body, determined by the location of the blood clot in the brain
Call your local emergency services or go to the emergency room (ER) if you’re having any of these symptoms.
People with a ministroke may temporarily find themselves unable to speak. After a ministroke, people may tell their doctor that they had difficulty recalling words during the event. Other speech problems may include trouble saying a word or trouble understanding words.
This condition is known as dysphasia. In fact, dysphasia is sometimes the only symptom of a ministroke.
Trouble speaking indicates that the blockage or blood clot that caused the ministroke occurred in the dominant brain hemisphere.
Temporary blindness in one eye
Sometimes a ministroke manifests as a particular visual disturbance known as amaurosis fugax. Amaurosis fugax is also known as transient monocular blindness (TMB).
In amaurosis fugax, a person’s vision in one eye becomes suddenly dimmed or obscured. The world turns gray or objects look blurry. This may last for seconds or minutes. Exposure to bright light can aggravate amaurosis fugax. You may not be able to read words on white pages.
Blood clots are the leading cause of ministrokes. Other common causes of this condition include:
The symptoms of a ministroke can last as briefly as one minute. By definition, ministrokes last for fewer than 24 hours.
Often, the symptoms are gone by the time you get to a doctor. Your symptoms may not be present while a doctor evaluates you, so you have to describe the event after your symptoms have disappeared.
Symptoms that come on suddenly and without warning could signify a stroke. “FAST” is an abbreviation to help you recognize some common stroke symptoms.
|F for face||If you notice a If you notice a droop or uneven smile on a person’s face, this is a warning sign. on a person’s face, this is a warning sign.|
|A for arms||Arm numbness or weakness can be a warning sign. You can ask the person to raise their arms if you’re unsure. It’s a warning sign if the arm drops down or isn’t steady|
|S for speech difficulty||Ask the person to repeat something. Slurred speech can indicate that the person is having a stroke.|
|T for time||Act fast if someone is experiencing stroke symptoms. It’s time to call 911 or your local emergency services.|
Call 911 or your local emergency services if you or someone around you has any of these symptoms.
High blood pressure is a major risk factor. It can damage the inner walls of the arteries, resulting in atherosclerosis. This plaque buildup can rupture and lead to blood clots in these arteries. These abnormalities can lead to a ministroke and stroke.
If you’ve received a high blood pressure diagnosis from your doctor, it’s important to keep track of your blood pressure on a routine basis. You should invest in a home blood pressure monitor to check your blood pressure.
Sometimes people have what’s called white coat syndrome. This means that your blood pressure can be higher than usual in your doctor’s office due to anxiety about having your blood pressure checked.
Keeping track of your blood pressure at home can give your doctor a more accurate assessment of your typical blood pressure. This information helps them adjust your blood pressure medications more effectively.
If you have an at-home machine, you should check your blood pressure immediately if you experience any of the following:
If you don’t have a way to check your blood pressure at home, you should call your doctor immediately or go to a local urgent care center or ER.
Shop for a home blood pressure monitor.
Other risk factors
Other risk factors for ministroke and stroke include:
According to a 2014 study:
A ministroke doesn’t lead to permanent brain damage, but you still need an urgent medical examination if you have symptoms of a ministroke.
That’s because the symptoms are identical to the symptoms of a stroke. It isn’t possible for you to tell whether they’re related to a ministroke or a stroke. The distinction requires a medical evaluation.
Unlike ministroke symptoms, stroke symptoms are permanent and do result in permanent damage to brain tissue. However, stroke symptoms may improve with time. Having a ministroke puts you at risk of a stroke, because ministrokes and strokes have the same causes.
If you’ve had a stroke, it’s likely that it won’t show up on a CT scan of your brain for 24 to 48 hours. An MRI scan usually shows a stroke sooner.
In evaluating the cause of the ministroke or stroke, your doctor will likely order an ultrasound to see if there’s significant blockage or plaque in your carotid arteries. You’ll also need an echocardiogram to look for blood clots in your heart.
Several treatment options are available. Ministrokes don’t cause lasting brain tissue damage or disabilities, but they can be an early warning sign of a stroke. Treatment for ministrokes focuses on starting or adjusting medications that improve blood flow to the brain.
It also requires identifying abnormalities that your doctor can fix to reduce your risk of future ministrokes or strokes.
Treatment options include drugs, medical procedures, and lifestyle changes.
Antiplatelet drugs make your platelets less likely to stick together to prevent blood clots. These medications include:
These medications prevent blood clots by targeting proteins that cause clotting, rather than targeting the platelets. This category includes:
If you’re taking warfarin, you’ll need close monitoring with blood tests to make sure you have the correct dosage. Drugs such as rivaroxaban and apixaban don’t require monitoring.
Minimally invasive carotid intervention
This is a surgical procedure that involves accessing the carotid arteries with a catheter.
The catheter is inserted through the femoral artery in your groin. The doctor uses a balloonlike device to open up clogged arteries. They’ll place a stent or small wire tube inside the artery at the point of narrowing to improve blood flow to the brain.
You may need surgery to prevent future strokes. If you have a severe narrowing of the carotid artery in your neck and aren’t a candidate for a carotid angioplasty and stenting, your doctor may recommend a surgery called a carotid endarterectomy.
In the procedure, your doctor clears the carotid arteries of fatty deposits and plaques. This can reduce the risk of another ministroke or a stroke.
Lifestyle changes may be necessary to reduce your risk of future ministrokes or strokes. Medications and other medical interventions may not be enough.
These lifestyle changes include:
- losing weight
- eating more fruits and vegetables
- reducing your intake of fried or sugary foods
- getting enough sleep
- reducing stress
- improving your control of other medical conditions, including diabetes, high blood pressure, and high cholesterol
Ministrokes and other types of strokes are sometimes unavoidable, but you can take precautions to help prevent ministrokes.
Follow these ministroke and stroke prevention tips:
- Don’t smoke.
- Avoid secondhand smoke.
- Eat a balanced diet with more fruits and vegetables.
- Maintain a healthy weight.
- Exercise regularly.
- Limit your alcohol intake.
- Don’t use illicit drugs.
- Control your diabetes.
- Limit your cholesterol and fat intake, especially saturated and trans fats.
- Make sure your blood pressure is under good control.
- Reduce stress.