| Less than half of the patients said they realized they | | | | mini-stroke, 40 per cent of sufferers are at risk of a |
| were having a transient ischemic attack when the | | | | further attack, about half of which occur within the first |
| symptoms started. But even those who suspected | | | | year. Like major strokes, mini-strokes occur largely as |
| TIA weren't quicker to seek medical attention. Almost | | | | a result of fatty material that builds up on artery walls, |
| all of the patients (96%) recalled their first impressions | | | | breaking off to lodge in small blood vessels leading to |
| of their symptoms. Of those patients, 42% said they | | | | the brain. Blood clots may, similarly, be dislodged and |
| thought they were having a transient ischemic attack. | | | | block the flow of blood. |
| However, knowing TIA's symptoms didn't spur people | | | | While there is consensus for rapid CT brain imaging, |
| to quickly seek medical help. As for the other patients | | | | there is not agreement about the timing of other tests, |
| who recalled their initial perception of their symptoms, | | | | such as carotid imaging. There is some interest in the |
| nearly one in three said they didn't initially know what | | | | use of an Accelerated Diagnostic Protocol (ADP), |
| caused their symptoms. The rest said they suspected | | | | coupled with an Emergency Department Observational |
| stress, eye problems, heart attack, or migraines were | | | | Unit, to avoid the average 3-day stay for admitted |
| to blame. | | | | patients. This protocol may lower costs and reduce |
| Diet, exercise and drugs like allopurinol (all of which | | | | hospital stays, but questions remain about the |
| lower UA levels) could eventually be of value in | | | | outcomes and overall quality of care that such patients |
| reducing this risk, especially for those with additional risk | | | | receive. |
| factors such as diabetes, obesity and hypertension, the | | | | A transient ischaemic attack (TIA) is usually defined as |
| researchers say. But they caution that it would be | | | | causing symptoms for less than 24 hours, but it is |
| premature to try this now. "Over a lifetime, it is | | | | unlikely that brain or eye is actually ischaemic for more |
| common to have a small number of these mini strokes | | | | than a few minutes. What we observe is the clinical |
| and not even notice," says Schretlen, "but as the | | | | effects of reversible impairment of neuronal function |
| overall volume of WMH increases, the damage can | | | | resulting from a short period of ischaemia. The risk of |
| seriously disrupt how quickly we think and how | | | | stroke after a TIA is about 12% in the first year and |
| effectively we learn and remember information." | | | | then about 7% a year thereafter, with risk of stroke, |
| Mini-strokes should never, as the Stroke Association | | | | heart attack or vascular death being about 10% a |
| points out, be ignored. In some cases, they are the | | | | year. This is about seven times the risk in the |
| prelude to another, usually more severe, attack. | | | | background population. But there is also a high risk of |
| Studies show that after one, the chance of a further, | | | | stroke in the seven days after a TIA, possibly as high |
| more serious occurrence during the following week is | | | | as 10%. |
| as high as 30 per cent. For five years after a | | | | |