Mini-Stroke
Introduction
Mini-Stroke is also called as Transient Ischemic Attack(TIA).
Rushing through the grocery store, you suddenly lose some of the feeling in your right arm and leg. You grab some shelves to steady yourself. You try to talk to a fellow shopper, but your words sound garbled and listeners seem confused by your speech. Then, after a few minutes, your signs and symptoms disappear and you go on with your shopping.
You may have experienced a temporary or intermittent neurological event called a Mini-Stroke. Ignoring this episode could have serious consequences for your health.
Even though a mini-stroke doesn't last very long and leaves no permanent effects, it's far from an insignificant event. About one in three people who have a transient ischemic attack eventually have a stroke, with about half occurring during the year after the transient ischemic attack.
A mini-stroke can serve as both a warning and an opportunity — a warning of an impending stroke and an opportunity to take steps to prevent it.
Signs and symptoms
Mini-Stroke usually last for a few minutes. Most signs and symptoms disappear within an hour, and, by definition, all effects disappear within 24 hours. The signs and symptoms of mini-stroke resemble those found early in a stroke and may include:
- Sudden weakness, numbness or paralysis in your face, arm or leg, typically on one side of your body
- Slurred or garbled speech or difficulty understanding others
- Sudden blindness in one or both eyes or double vision
- Dizziness, loss of balance or loss of coordination
Causes
The cause of a mini-stroke is a temporary decrease in blood supply to part of your brain. Most attacks last just a few minutes.
A mini-stroke has the same origins as that of an ischemic stroke. In ischemic strokes, which are the most common type of stroke, a clot blocks the blood supply to part of your brain. But in contrast to a stroke, which involves a more prolonged lack of blood supply and causes some permanent damage to your brain tissue, a mini-stroke doesn't leave lasting effects to your brain.
The underlying cause of a mini-stroke often is a buildup of cholesterol-containing fatty deposits called plaques (atherosclerosis) in an artery or one of its branches that supply oxygen and nutrients to your brain. Plaques can decrease the blood flow through an artery or lead to the development of a clot. Other causes include a blood clot moving to your brain from another part of your body, most commonly from your heart.
Treatment
Once your doctor has determined the cause of your mini-stroke, the goal of treatment is to correct the abnormality and prevent a stroke. Depending on the cause of your mini-stroke, your doctor may prescribe medication to reduce the tendency for blood to clot or may recommend surgery or a balloon procedure (angioplasty).
Medications
Doctors use several medications to decrease the likelihood of a stroke after a transient ischemic attack. The medication selected depends on the location, cause, severity and type of mini-stroke. Two frequently prescribed types of drugs are:
- Anti-platelet drugs. These medications make your platelets, one of the circulating blood cell types, less likely to stick together. Clot formation is started by sticky platelets when there's an injury to blood vessels. The process is then completed by clotting proteins in blood plasma. The most frequently used anti-platelet medication is aspirin. Aspirin is also the least expensive treatment with the fewest potential side effects. An alternative to aspirin is the anti-platelet drug clopidogrel (Plavix). Your doctor may also consider prescribing Aggrenox, a combination of low-dose aspirin and the anti-platelet drug dipyridamole, to reduce blood clotting. The way dipyridamole works is slightly different from aspirin. Ticlopidine (Ticlid) is another anti-platelet medication that doctors occasionally recommend.
- Anticoagulants. These drugs include heparin and warfarin (Coumadin). They affect clotting-system proteins instead of platelet function. Heparin is used short term and warfarin over a longer term. These drugs have a strong anticoagulation effect and therefore require careful monitoring.
Surgery and angioplasty (stenting)
If you have a moderately or severely narrowed neck (carotid) artery, your doctor may suggest carotid endarterectomy (end-ahr-tur-EK-tuh-me). This preventive surgery clears carotid arteries of fatty deposits (atherosclerotic plaques) before another TIA or stroke can occur. An incision is made to open the artery, the plaques are removed, and the artery is closed.
In selected cases, a procedure called carotid angioplasty, or stenting, is an option. This procedure involves using a balloon-like device to open a clogged artery and placing a small wire tube (stent) into the artery to keep it open.
Prevention
Knowing your risk factors and living healthfully are the best things you can do to prevent a mini-stroke. Included in a healthy lifestyle are regular medical checkups. Also:
- Don't smoke. Stopping smoking reduces your risk of a TIA or a stroke.
- Limit cholesterol and fat. Cutting back on cholesterol and fat, especially saturated fat, in your diet may reduce buildup of plaques in your arteries.
- Eat plenty of fruits and vegetables. These foods contain such nutrients as potassium, folate and antioxidants, which may protect against a TIA or a stroke.
- Limit sodium. If you have high blood pressure, avoiding salty foods and not adding salt to food may reduce your blood pressure. Avoiding salt may not prevent hypertension. But excess sodium may increase blood pressure in people who are sensitive to sodium.
- Exercise regularly. If you have high blood pressure, regular exercise is one of the few ways you can lower your pressure without drugs.
- Limit alcohol intake. Drink alcohol in moderation, if at all. The recommended limit is no more than one drink daily for women and two a day for men.
- Maintain a healthy weight. Being overweight contributes to other risk factors, such as high blood pressure, cardiovascular disease and diabetes. Losing weight with diet and exercise may lower your blood pressure and improve your cholesterol levels.
- Don't use illicit drugs. Drugs such as cocaine are associated with an increased risk of a TIA or a stroke.
- Control diabetes. You can manage both diabetes and high blood pressure with diet, exercise, weight control and, when necessary, medication.
Credit: National Institute of Health.