Although transient ischemic attacks may be deemed by physicians as too mild to treat, such "mini-strokes" can lead to serious disability, according to a study.
"Our study shows that TIA and minor stroke patients are at significant risk of disability and need early assessment and treatment," Shelagh Coutts, MD, the study’s lead author, said in a news release.
"We should be imaging patients earlier and be more aggressive in treating patients with thrombolysis if we can see a blockage no matter how minor the symptoms are," added Coutts, of Foothills Hospital in Calgary, Alberta.
TIA and minor stroke patients typically do not receive thrombolysis because the condition is frequently not deemed serious enough to warrant it, the researchers said.
Among the 499 patients studied, 15% had at least minor disability 90 days after their original TIA. Minor disability was defined as being unable to carry out some previous activities, but capable of handling personal affairs without assistance.
Computed tomography scans showed some TIA patients had narrowed blood vessels in the brain, and others reported ongoing or worsening symptoms. Those patients were more than twice as likely to have disability at 90 days. Coutts suggested thrombolysis treatment should be considered in these patients.
Patients with type 2 diabetes had a similarly high risk of disability. Also, women were nearly twice as likely as men to be disabled 90 days after TIA.
"For every second after a mini-stroke, the patient’s brain may be losing oxygen — possibly leading to a major event," Coutts said. "If a scan finds that you have a narrowing of a blood vessel in or outside of the brain, you are at high risk of being disabled."
Recurrent strokes posed the greatest threat to patients. Of those who had recurrent strokes, 53% were disabled, compared with 12% of other patients.
In 2009, the American Heart Association/American Stroke Association recommended immediate action and thorough testing for TIA — much like the exams performed after a full-blown stroke. These exams can show blockage in a brain blood vessel, which can increase patients’ risk of a subsequent, more serious event.
"The symptoms of a TIA — abrupt onset of inability to move one side of your body, numbness on one side, dizziness and trouble walking — may pass quickly," Coutts said. "But if you experience them, you should immediately go to the hospital, where proper scans can be done. If ignored, these symptoms can lead to death. This is not a benign disease."
Coutts said researchers have started a trial in Canada to investigate the efficacy of giving clot-busting drugs to patients with mild symptoms but with blocked blood vessels in the brain.
The study appeared Sept. 13 on the website of Stroke, a journal of the American Heart Association. The study abstract is available at http://stroke.ahajournals.org/content/early/2012/09/13/STROKEAHA.112.665141.abstract.
"Our study shows that TIA and minor stroke patients are at significant risk of disability and need early assessment and treatment," Shelagh Coutts, MD, the study’s lead author, said in a news release.
"We should be imaging patients earlier and be more aggressive in treating patients with thrombolysis if we can see a blockage no matter how minor the symptoms are," added Coutts, of Foothills Hospital in Calgary, Alberta.
TIA and minor stroke patients typically do not receive thrombolysis because the condition is frequently not deemed serious enough to warrant it, the researchers said.
Among the 499 patients studied, 15% had at least minor disability 90 days after their original TIA. Minor disability was defined as being unable to carry out some previous activities, but capable of handling personal affairs without assistance.
Computed tomography scans showed some TIA patients had narrowed blood vessels in the brain, and others reported ongoing or worsening symptoms. Those patients were more than twice as likely to have disability at 90 days. Coutts suggested thrombolysis treatment should be considered in these patients.
Patients with type 2 diabetes had a similarly high risk of disability. Also, women were nearly twice as likely as men to be disabled 90 days after TIA.
"For every second after a mini-stroke, the patient’s brain may be losing oxygen — possibly leading to a major event," Coutts said. "If a scan finds that you have a narrowing of a blood vessel in or outside of the brain, you are at high risk of being disabled."
Recurrent strokes posed the greatest threat to patients. Of those who had recurrent strokes, 53% were disabled, compared with 12% of other patients.
In 2009, the American Heart Association/American Stroke Association recommended immediate action and thorough testing for TIA — much like the exams performed after a full-blown stroke. These exams can show blockage in a brain blood vessel, which can increase patients’ risk of a subsequent, more serious event.
"The symptoms of a TIA — abrupt onset of inability to move one side of your body, numbness on one side, dizziness and trouble walking — may pass quickly," Coutts said. "But if you experience them, you should immediately go to the hospital, where proper scans can be done. If ignored, these symptoms can lead to death. This is not a benign disease."
Coutts said researchers have started a trial in Canada to investigate the efficacy of giving clot-busting drugs to patients with mild symptoms but with blocked blood vessels in the brain.
The study appeared Sept. 13 on the website of Stroke, a journal of the American Heart Association. The study abstract is available at http://stroke.ahajournals.org/content/early/2012/09/13/STROKEAHA.112.665141.abstract.
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