The major problem of ministrokes

An estimated 795,000 people get a first-time stroke every year, and there is a good chance they were warned. Transient ischemic attacks (TIAs), also known as ministrokes, share many of the typical stroke symptoms. Yet they often are mild and brief, which is why they routinely get missed or ignored.

“A TIA is your body sounding a loud alarm that you’re at high risk for a full stroke, and you need to listen,” says Dr. Erica Camargo Faye, a stroke neurologist at Harvard-affiliated Massachusetts General Hospital.

Different kinds of blockage

A TIA occurs when not enough oxygen-rich blood reaches part of the brain. Often, the underlying cause is fatty plaque buildup inside arteries in the neck, such as the carotid artery, or in the brain itself. The plaque narrows the arteries and also invites a blood clot (called a thrombus) to form on top of the plaque, making it hard for blood to flow past it.

Another cause is a blood clot in the heart or the carotid artery that breaks off, travels to the brain, and temporarily blocks a blood vessel there. Similarly, a drop in blood pressure can slow blood flow through a narrowed part of an artery.

The signs of TIA are the same as a regular stroke and include one or more of the following, according to the CDC:

  • numbness or weakness of the face, arm, or leg, especially on one side of the body
  • confusion, problems speaking or understanding speech, slurred speech
  • vision problems, including double vision, loss of vision in one eye, or loss of vision on one side of the visual field
  • trouble walking, dizziness, loss of balance or coordination.

TIAs typically last anywhere from approximately 30 seconds to 10 to 20 minutes, although they can go on for up to an hour or longer. “TIAs also can happen when you are asleep, and you may never know it happened,” says Dr. Camargo Faye.

TIAs often recur with no pattern. “The same symptoms can appear, or there can be new ones,” she says. “Less commonly, attacks may become progressively worse.”

These attacks can be tough to recognize because people often blame normal aging for symptoms such as taking a sudden stumble while walking, trouble getting out the right words, or feeling dizzy. “And because TIAs don’t last long and don’t always have an immediate lasting effect, it’s easy for people to shrug them off,” says Dr. Camargo Faye.

BE-FAST to recognize strokeThe American Stroke Association coined the acronym FAST to help people recognize stroke symptoms in others and themselves. FAST stands for Face drooping; Arm weakness; Speech difficulties; Time to call 911. But some neurologists suggest adding two letters to the front — B for balance (sudden loss of balance or coordination) and E for eyes (blurring or vision loss in one or both eyes) — which can help identify even more potential strokes. “About two-thirds of major strokes have one of these signs,” says Dr. Erica Camargo Faye, a stroke neurologist at Harvard’s Massachusetts General Hospital.

Know the risks

A TIA does not guarantee you will have a future stroke; it only tells you that you are at high risk. According to the American Heart Association, about 9% to 17% of people who experience a TIA have a stroke within 90 days.

“If you notice any symptoms, even if they only last for several seconds, you should react as if it’s a major stroke and seek immediate medical care,” says Dr. Camargo Faye.

This applies even if you have known conditions that can mimic a TIA, such as vertigo or dizziness from low blood pressure. “It’s always best to err on the side of caution, and at least discuss the symptoms with your doctor,” she adds.

Preventing a TIA

TIAs and regular strokes also share many risk factors, such as smoking, high blood pressure, alcohol misuse, diabetes, a high cholesterol level, and excessive weight gain.

Another condition linked to TIA is atrial fibrillation, a quivering or irregular heartbeat. The uncoordinated movement of the atria (the upper chambers of the heart) can lead to the formation of a blood clot that can then travel to the brain and cause a TIA.

Some research suggests that excessive amounts of testosterone replacement therapy could increase a man’s risk of cardiovascular disease, raising his TIA and stroke risk.

“It is essential men get regular check-ups to identify these problems so they can make appropriate diet and lifestyle changes,” says Dr. Camargo Faye.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

 “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.” – Philippians 4:8

 “Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.” – Mark 11:24

 “Anxiety weighs down the heart, but a kind word cheers it up.” – Proverbs 12:25

 “Who of you by worrying can add a single hour to your life?” – Luke 12:25

 “For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.” – Jeremiah 29:11

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11

 “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22

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