Signs of a Mini Stroke
What is a mini stroke?
A mini stroke also know as a transient ischemic attack, TIA for short is a transient episode of neurological dysfunction caused by a temporary fall in the blood supply to part of the brain, leading to a lack of oxygen to the brain. Mini strokes cause the same symptoms as a normal stroke, generally the symptoms don't last as long. Unlike a normal stroke during a mini strokes tissue damage doesn't occur. Mini Strokes the same as strokes are caused by a disruption of the cerebral blood flow. Many people develop the signs of a mini stroke but never seem medical help this makes it very difficult to know exactly how common they are. An estimate of the number of mini strokes is one in one thousand.
What are the Signs Of a Mini Stroke?
The signs of a mini stroke and strokes cause the same symptoms, such as contralateral paralysis (opposite side of body from affected brain hemisphere) or sudden weakness or numbness. A mini stroke may cause sudden dimming or loss of vision, aphasia, slurred speech and mental confusion.
Unlike a stroke, the signs of a mini stroke can resolve within a few minutes or 24 hours. Brain injury can still occur in a mini stroke lasting only a few minutes. Having a mini stroke is a risk factor for eventually having a stroke or silent stroke. A silent Stroke or silent cerebral infarct (SCI) differs from a mini strokes in that there are no immediately observable symptoms. A SCI may still cause long lasting neurological dysfunction affecting such as mood, personality and cognition. A SCI often occurs before or after a mini stroke or major stroke.
Signs of a Mini Stroke
The signs of a mini stroke vary from person to person, depending on the area of the brain involved. The most frequent symptoms include:-
- Temporary loss of vision (typically amaurosis fugax)
- Difficulty speaking (aphasia)
- Weakness on one side of the body (hemiparesis)
- Numbness or tingling (paresthesia), usually on one side of the body.
Impairment of consciousness is very uncommon. There have been cases of temporary and partial paralysis affecting the face and tongue of the afflicted. The signs of a mini stroke are short-lived and usually last a few seconds to a few minutes and most symptoms disappear within 60 minutes. Some individuals may have a lingering feeling that something odd happened to the body. Dizziness, lack of coordination or poor balance are also symptoms related to mini strokes. Symptoms vary in severity.
Because the brain is a large organ, the whole side of an individual's body doesn't need to be affected. Signs of a mini stoke may be limited to an arm or leg or part of the face. The deficits are also grouped based on the anatomy of the brain. As an example, loss of speech (aphasia) is associated with weakness or numbness on the right side of the body, since speech is controlled by the left of the brain. These symptoms are associated with problems in the anterior circulation from the carotid arteries.
If you have signs of a mini stroke, seek medical attention urgently. Mini strokes are a warning sign that further mini strokes, or a full stroke, may occur soon.
Mini Stroke Diagnosis
Without treatment, there is a one in 10 chance that you will have a full stroke within four weeks of having a mini stroke. A stroke is a serious condition and can cause permanent disability. In some cases, strokes can be fatal.
Mini Strokes are diagnosed by the patients history, because often neurological deficits have most likely resolved before. During diagnosis risk from strokes and heart disease are assessed by looking for high blood pressure, high cholesterol, diabetes, family history and smoking.
The heart will be examined monitoring rate and rhythm along with the lungs. The neck will be examined as well listening for bruits (abnormal sound made when blood rushing through narrowed blood vessels. A full neurologic exam will be undertaken and may include looking for weakness or numbness; assessing walk and coordination; and checking vision, hearing, speech, and language comprehension.
Other tests that may be considered include:
Mini Stroke Treatment
- Electrocardiogram (EKG) and monitoring to look for irregular heart rhythms like atrial fibrillation.
- CT scan of the head to look for bleeding in the brain. Strokes do not appear right away on a CT scan. It is a test to rule out bleeding, not to confirm a stroke or mini stroke.
- Carotid ultrasound is a test to look for narrowing of the blood vessels in the anterior part of the neck that provide the majority of blood supply to the brain.
- Basic blood tests may include a CBC (complete blood count) to look for anemia or problems with too many or too few platelets. Patients who take warfarin (Coumadin) (a blood thinner to prevent blood clots from atrial fibrillation) will have their blood tested to make certain the medication dosage is appropriate. If there is concern that there may be clots coming from the heart or debris coming from heart valves, then an echo-cardiogram (ultrasound examination of the heart) may be indicated to help with the diagnosis as to the origin of the mini stroke.
Mini stroke treatment is aimed at preventing a future stroke.
- Minimizing risk factors is a priority, including optimizing blood pressure,cholesterol and lipid levels, and controlling diabetes.
- Aspirin is the drug of choice to prevent future mini stroke or stroke. Aspirin makes platelets less sticky and prevents clot formation.
- If the mini stroke occurs when the patient is already taking aspirin, then alternative anti-platelet drugs like clopidogrel bisulfate(Plavix) or aspirin-dipyridamole ER(Aggrenox) may be indicated.
- If the carotid ultrasound shows major narrowing of the artery (stenosis), referral to a vascular surgeon may be necessary to unclog the artery with a procedure known as carotid endarterectomy.