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Is it a Mini-Stroke?

Nov 25, 2008

Johns Hopkins defines a mini stroke or more correctly a transient ischemic attack (TIA) as: short-lived and reversible symptoms of a stroke that are caused by a temporary reduction in blood flow to the brain. Most episodes subside within five to 20 minutes.

For TIAs, under diagnosing can be hazardous because suffering with a TIA increases your risk of developing a full-blown stroke. About 15 % of diagnosed strokes are preceded by a TIA and having a TIA temporarily significantly boosts the risk of developing a stroke. However, a TIA is difficult to assess because the neurological dysfunction is brief and by the time the patient sees a doctor the symptoms could have disappeared.

Neurologists at Rush University Medical Center have identified three clinical features that can help more accurately distinguish the diagnosis of TIA from other disorders that may mimic it. The researchers examined the records of 100 emergency room patients who were initially diagnosed with a TIA and were admitted for further evaluation. Only 40 of the patients or 40% turned out to be true TIA patients.

The researchers were able to identify three clinical features that together, correctly classified 79 % of the cases.

1) Speed of onset was the strongest indicator of a TIA; if the symptoms came on like lightning, within seconds according to the authors. Other neurological problems that mimic a TIA, such as a migraine or seizure, take more than a minute to develop.

2) The researchers found that a TIA was unlikely if the patient reported nonspecific symptoms such as lightheadedness, tightness in the chest, upset stomach, along with the neurological dysfunction.

3) A TIA was also unlikely if the patient had a history of similar episodes where a TIA was ruled out.

The study is published in the December 2008 issue of the journal Cerebrovascular Diseases.

The Symptoms of a stroke according to the Mayo Clinic are the following;
Watch for these stroke symptoms if you think you or someone else is having a stroke:

  • Trouble with walking. If you're having a stroke, you may stumble or have sudden dizziness, loss of balance or loss of coordination.
  • Trouble with speaking. If you're having a stroke, you may slur your speech or may not be able to come up with words to explain what is happening (aphasia). Try to repeat a simple sentence. If you can't, you may be having a stroke.
  • Paralysis or numbness on one side of the body. If you're having a stroke, you may have sudden numbness, weakness or paralysis on one side of the body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke.
  • Trouble with seeing. If you're having a stroke, you may suddenly have blurred or blackened vision or may see double.
  • Headache. A sudden, severe "bolt out of the blue" headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between your eyes, vomiting or altered consciousness, sometimes indicates you're having a stroke.

The signs and symptoms of TIA are the same as for a stroke, but they last for a shorter period — several minutes to 24 hours — and then disappear, without leaving apparent permanent effects.