Mini-stroke patients need swift treatment

People often suffer mini-strokes days before a major stroke and should seek help within hours to get the most effective treatment, British researchers have reported.

The study, published in the March 8 issue of the journal Neurology, suggests that doctors should act more quickly in investigating symptoms of a mini-stroke, which can be vague.

Mini-strokes are known as transient ischemic attacks, or TIAs, and, like major strokes, they have symptoms such as nausea, sudden loss of balance or consciousness, or vision disturbances. But these symptoms last just a few minutes.

“We have known for some time that TIAs are often a precursor to a major stroke,” said Dr. Peter Rothwell, a neurologist at Radcliffe Infirmary in Oxford, England. “What we haven’t been able to determine is how urgently patients must be assessed following a TIA in order to receive the most effective preventive treatment. This study indicates that the timing of a TIA is critical, and the most effective treatments should be initiated within hours of a TIA in order to prevent a major attack.”

Rothwell and his colleagues studied 2,416 people who had ischemic strokes -- major strokes caused by a blockage of an artery in the brain. About 80% of strokes are ischemic. The rest are hemorrhagic strokes, caused by a broken blood vessel.

The researchers found that 549 of the stroke patients had experienced a TIA.

“Where a preceding TIA had occurred, the timing was highly consistent across the studies, with 17% occurring on the day of the stroke, 9% on the previous day, and 43% at some point during the 7 days prior to the stroke,” Rothwell’s team wrote in their report.

The National Institute of Neurological Disorders and Stroke says about a third of patients who have a TIA will have a bigger stroke at some point.

Aspirin or prescription blood thinners can be used to help prevent stroke, and patients can be told to watch their diet, exercise more and, especially, quit smoking.