Published: Tuesday, December 23, 2008
Nothing minor about threat from mini-strokes
A mini-stroke is a stroke that quickly comes and goes. The condition, also known as transient ischemic attack, happens when a blood clot suddenly blocks a blood vessel in your brain. This causes the blood supply to your brain to temporarily stop.
If the blood flow is not restored, a full-fledged stroke can occur; but this outcome can be prevented in several ways.
Here are answers to mini-stroke questions that I'm often asked.
Question: How long does it last?
Answer: Most symptoms of a mini-stroke disappear within an hour, though they may persist for up to 24 hours. Symptoms include numbness and weakness, especially on one side of the body; confusion; difficulty speaking or understanding speech; double vision or sudden loss of vision in one or both eyes; or problems with walking, balance or coordination.
Question: Are there any consequences?
Answer: A mini-stroke is a warning sign that a person is at high risk for stroke. About one-third of those who have one will go on to suffer a stroke in the future.
Stroke risk is highest soon after a attack. Five percent to 10 percent of patients with a mini-stroke will have a stroke within the following week.
The 240,000 U.S. adults who are diagnosed with a transient ischemic attack every year are also at increased risk for cardiovascular disease, heart attacks, and sudden death.
Question: What is the treatment?
Answer: Since you can't tell initially if the symptoms you're having are from a transient ischemic attack or a stroke, you should call 911 or go immediately to an emergency room, according to the National Institute of Neurological Disorders and Stroke. A diagnosis can be made based primarily on your history and physical examination. Confirmatory tests such as blood tests, x-rays or imaging may be ordered.
Depending on the results of your evaluation, your attending physician may recommend a medication, or in some cases surgery, to help reduce your chance of having a future stroke.
Agents that make blood platelets less sticky, such as aspirin or other anti-platelet drugs, are the standard treatment for patients at risk for stroke. A blood-thinner called warfarin may be advised for people with a heart arrhythmia called atrial fibrillation.
Question: How can it be prevented?
Answer: Many full-blown strokes could be prevented by recognizing such attacks and treating the underlying risk factors. The leading treatable risks for transient ischemic attacks are high blood pressure, coronary heart disease, carotid artery disease in the neck, diabetes, smoking and heavy use of alcohol.
Medical care that is personalized to your needs can help control or eliminate these factors. Lifestyle changes such as eating a nutritious diet, maintaining a healthy weight and enrolling in programs to help stop the use of tobacco or excess alcohol can also reduce these factors.
Question: What kind of diet helps?
Answer: A diet low in saturated fat and cholesterol can help reduce the risk of mini-strokes and subsequent stroke. So can eating five or more servings of fruits and vegetables a day. The most-protective choices are leafy greens, vegetables in the cabbage family such as broccoli and cauliflower, and citrus, according to research.
Question: Does exercise reduce risk?
Answer: Regular physical activity lowers your chance of developing several risk factors for transient ischemic attack, including heart disease, high blood pressure, diabetes and obesity. The National Stroke Association recommends getting at least 30 minutes of moderate exercise five days a week. Be sure to work up to that level gradually under the guidance of your doctor.
For more information: National Stroke Association, www.stroke.org.
Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column, consult your health care provider.
© 2008 Elizabeth S. Smoots
If the blood flow is not restored, a full-fledged stroke can occur; but this outcome can be prevented in several ways.
Here are answers to mini-stroke questions that I'm often asked.
Question: How long does it last?
Answer: Most symptoms of a mini-stroke disappear within an hour, though they may persist for up to 24 hours. Symptoms include numbness and weakness, especially on one side of the body; confusion; difficulty speaking or understanding speech; double vision or sudden loss of vision in one or both eyes; or problems with walking, balance or coordination.
Question: Are there any consequences?
Answer: A mini-stroke is a warning sign that a person is at high risk for stroke. About one-third of those who have one will go on to suffer a stroke in the future.
Stroke risk is highest soon after a attack. Five percent to 10 percent of patients with a mini-stroke will have a stroke within the following week.
The 240,000 U.S. adults who are diagnosed with a transient ischemic attack every year are also at increased risk for cardiovascular disease, heart attacks, and sudden death.
Question: What is the treatment?
Answer: Since you can't tell initially if the symptoms you're having are from a transient ischemic attack or a stroke, you should call 911 or go immediately to an emergency room, according to the National Institute of Neurological Disorders and Stroke. A diagnosis can be made based primarily on your history and physical examination. Confirmatory tests such as blood tests, x-rays or imaging may be ordered.
Depending on the results of your evaluation, your attending physician may recommend a medication, or in some cases surgery, to help reduce your chance of having a future stroke.
Agents that make blood platelets less sticky, such as aspirin or other anti-platelet drugs, are the standard treatment for patients at risk for stroke. A blood-thinner called warfarin may be advised for people with a heart arrhythmia called atrial fibrillation.
Question: How can it be prevented?
Answer: Many full-blown strokes could be prevented by recognizing such attacks and treating the underlying risk factors. The leading treatable risks for transient ischemic attacks are high blood pressure, coronary heart disease, carotid artery disease in the neck, diabetes, smoking and heavy use of alcohol.
Medical care that is personalized to your needs can help control or eliminate these factors. Lifestyle changes such as eating a nutritious diet, maintaining a healthy weight and enrolling in programs to help stop the use of tobacco or excess alcohol can also reduce these factors.
Question: What kind of diet helps?
Answer: A diet low in saturated fat and cholesterol can help reduce the risk of mini-strokes and subsequent stroke. So can eating five or more servings of fruits and vegetables a day. The most-protective choices are leafy greens, vegetables in the cabbage family such as broccoli and cauliflower, and citrus, according to research.
Question: Does exercise reduce risk?
Answer: Regular physical activity lowers your chance of developing several risk factors for transient ischemic attack, including heart disease, high blood pressure, diabetes and obesity. The National Stroke Association recommends getting at least 30 minutes of moderate exercise five days a week. Be sure to work up to that level gradually under the guidance of your doctor.
For more information: National Stroke Association, www.stroke.org.
Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column, consult your health care provider.
© 2008 Elizabeth S. Smoots
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