Text/Professor Pan Huaizong/Jin Datiao News Network
▲ (Schematic diagram/Pixabay)
What is a “mini-stroke”?
Commonly known as a small stroke in the society, the scientific name is transient ischemic attack (TIA), which means that the blood flow to the brain is temporarily blocked. However, because the symptoms usually disappear within an hour (there are also relatively long periods of time, the scientific definition is less than 24 hours), and imaging examinations will not reveal any existing vascular obstruction, so TIA will not cause permanent damage to the human body , and disappear quickly, many people will ignore it and not go to the doctor. According to the statistics of the Ministry of Health and Welfare of Taiwan, 96% of Taiwanese people seek medical treatment immediately for stroke, but only 50% of people seek immediate medical treatment for minor stroke. The public lacks awareness of minor strokes and neglects them too much. Medical research shows that nearly 17.8% of TIA patients will have a stroke within three months after TIA, and nearly half of them will have a stroke within two days. For this reason, the American College of Cardiology published a Scientific Statement in the international journal “Stroke” on January 19, 2023, emphasizing the need for emergency assessment and active prevention of general stroke after TIA occurs, and It is believed that TIA should be more accurately translated as “alarm before the onset of stroke”, which will have a more warning effect.
How to identify “mini-stroke”?
TIA symptoms can be said to be nearly identical to those of a stroke, except that they are brief and fully recovered. TIAs come on suddenly and usually have any or all of the following characteristics: symptoms are intense at first but then subside, symptoms are usually less than an hour, facial Drooping, weakness or numbness on one side of the body, trouble speaking/slurring words, and dizziness/loss of vision or trouble walking. In addition, the health education (FAST) that the medical community teaches everyone to speak very colloquially about stroke symptoms can also be used to identify TIA, F stands for Face (facial drooping or numbness), A stands for Arm (weakness of arm), S stands for Speak (difficulty speaking) , T is Time (immediately seek medical attention, even if symptoms disappear)
Who is prone to “mini-stroke”?
In general, people with high blood pressure, diabetes, obesity, hypercholesterolemia, and smoking are at higher risk of stroke and TIA. Other risk factors that increase the risk of TIA include peripheral arterial disease, atrial fibrillation, obstructive Sleep apnea and coronary artery disease, among others. Of course, if a person has a history of stroke, the risk of TIA is relatively high.
The statement mentioned that magnetic resonance imaging (MRI) is the preferred method for confirming stroke, preferably within 24 hours of the onset of symptoms, and of course blood tests are also used to rule out other conditions that may cause TIA-like symptoms, such as Low blood sugar or infection, blood can also check cardiovascular risk factors, such as blood sugar and cholesterol levels. Once a TIA is diagnosed, the statement recommends that a cardiac examination should be performed, because heart-related factors can also cause TIA, such as the evaluation of heart rhythm by ECG to screen for atrial fibrillation. In the United States, as many as 7% of stroke or TIA patients, atrial fibrillation is detected . If a heart rhythm-related problem is confirmed to be the cause of the TIA or stroke, heart monitoring is done for six months after the TIA.
Because the risk of stroke is high within a few days after a TIA, it is best to visit a neurovascular specialist within 48 hours (but no more than a week) after a TIA, and previous studies have known that approximately 43% of ischemic strokes , TIA actually occurred within a week before the stroke, but many people did not notice it, which is very regrettable.
The most important thing after a “mini-stroke” is to take medicine and prevent the stroke from happening
After the patients with minor stroke are discharged from the hospital, many people still have insufficient knowledge about the symptoms and signs of stroke, let alone if the patients with minor stroke do not need to be hospitalized because they are quite mild, they only need to go home for observation. That’s why the American Heart Association calls for active health education for patients and their families before going home, when to return to the emergency department, and the importance of taking medication on time at this stage, so as to prevent the occurrence of stroke.
The scientific statement was prepared by a volunteer writing group representing the Emergency/Neurovascular Care Committee of the American College of Cardiology Stroke Group and Peripheral Vascular Disease Group, and was endorsed by the American Academy of Neurological Surgeons.
references:
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Hardik P. Amin, Tracy E. Madsen, Dawn M. Bravata, Charles R. Wira, S. Claiborne Johnston, Susan Ashcraft, Tamika M. Burrus, Peter D. Panagos, Max Wintermark, Charles Esenwa. Diagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association. Stroke, 2023; DOI: 10.1161/STR.0000000000000418
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