Some people receive a warning from their body that a serious stroke is on the way, a warning that comes in the form of a “mini-stroke,” known by some as a transient ischemic attack (TIA). A new study from Loyola University has scientists discussing the best way to approach medical care following a TIA. The general consensus? Don’t ignore the only warning you might get.
TIAs are, like strokes, caused by a blockage of blood flow to the brain, but the blockage is only temporary and leaves no permanent brain damage. Symptoms like paralysis on one side of the body or speech impediment dissipate as fast as they came, as problematic blood clots either loosen and float away or just dissolve. However harmless TIAs may seem on the surface, they are still a warning that more severe strokes are in the future.
TIAs are often predictive of a future stroke; the American Heart Association estimates that each TIA carries about an eight percent risk of stroke in the days following a TIA. Lead authors of the new Loyola University study, Camilo R. Gomez, MD, Michael J. Schneck, MD, and José Biller, MD, say that TIAs provide an “opportunity to prevent a disabling event.”
The big question these doctors are asking is whether to hospitalize TIA patients or to evaluate them as outpatients. Convenience, cost-effectiveness, and safety are all concerns they have; neither approach is perfect. In the past, TIA patients have been hospitalized for 23 hours after the event for evaluation, but now researchers suggest a slight modification: the “TIA clinic.”
A TIA clinic has stroke neurologists on call, diagnostic tests to be given, and other specialists available on an as-needed basis. Depending on a particular patient’s needs, they could be given antiplatelet therapy to prevent these clotting cells from sticking together (aspirin does this), blood-thinning drugs, stent placement to open clogged arteries, drugs for blood pressure and cholesterol management, diabetes screening, and patient education. At the TIA clinic, the main goal is to prevent future strokes.
As for patient education, Gomez, Schneck, and Biller strongly recommend that patients be “counselled about smoking cessation, proper diet (preferably Mediterranean), regular exercise, maintenance of appropriate BMI (body mass index) and limiting alcohol consumption.”
All three neurologists specialize in stroke care, and they emphasize that a TIA is more than just a close call; it’s a reality check for people at risk for more serious strokes in the near future. Acknowledging this warning is crucial for people who need to realize that certain lifestyle changes - and potentially surgical procedures - are vital to preventing stroke and living longer.
The present study was published in the journal F1000 Research.
Sources: American Stroke Association, American Heart Association, Loyola University Health System
