What Is a Mini Stroke?

When it comes to signs of a stroke you may have heard the phrase “time is brain,” which means to go to the emergency department right away to get crucial time-sensitive treatment. But what should you do if symptoms resolve on their own?

A transient ischemic attack (TIA) or “mini stroke” has the same symptoms as a regular stroke, but they resolve in about 20 to 30 minutes. Even if those symptoms go away, you should still seek emergency care because a mini stroke is a warning sign.

“It’s important for patients and clinicians to understand what a TIA actually represents, which is a heightened risk of future stroke. A TIA happens because there’s something going on in the body that’s leading to an interruption in blood flow to the brain,” said vascular neurologist Hardik Amin, MD, Medical Stroke Director of Yale New Haven Hospital’s Saint Raphael Campus. “The risk of stroke after a TIA over the next 90 days can be 18% or higher, and many of those strokes can occur over the next few days.”

Future strokes can be fatal or potentially disabling, leading to paralysis on one side of the body, inability to speak or eat.

Symptoms of a mini stroke

Common symptoms of a mini stroke can include:

• Sudden onset of trouble speaking or slurring of speech
• Drooping on one side of the face
• Sudden vision loss
• Weakness or numbness on either the right or left side of the body

Dr. Amin says one common misconception about strokes is that they are painful. Therefore, it’s easier to ignore symptoms, especially if they resolve on their own. But any sudden onset of symptoms should prompt you or loved ones to dial 9-1-1.

Treatments for a stroke

In the emergency department there is no traditional “treatment” for a mini stroke, unlike with a regular stroke, because patients are usually better by the time they get to the hospital. However, patients need to get a proper evaluation from a neurologist and CT or MRI imaging to understand why the TIA happened.

In a recently published paper in the American Heart Association Journal Stroke, Dr. Amin and coauthors urge for standardized TIA evaluations in emergency departments nationwide. Establishing the proper protocols for patients could improve outcomes, especially in areas where stroke experts are not readily available. Yale New Haven Health’s telestroke program gives patients at hospitals across Connecticut and Rhode Island the opportunity to be assessed by a stroke specialist 24/7.

Mini stroke risk factors

Once a patient is diagnosed with a TIA, they can be proactive about reducing their risk of future stroke because many underlying risk factors can be treated or managed.

The most common risk factors for mini stroke include hypertension or high blood pressure, diabetes, smoking and hyperlipidemia or high cholesterol. Other risk factors can include irregular heart rhythms such as atrial fibrillation or A-fib. Sometimes a mini stroke is the first sign a patient gets that clues them in to an underlying risk factor.

Those with high blood pressure may benefit from medication and stroke survivors are usually prescribed a blood thinner. Making important lifestyle changes like following a heart-healthy diet and avoiding smoking and excessive drinking can also help people reduce their risk of stroke.

If you suspect you’ve had a mini stroke in the past and aren’t sure, Dr. Amin recommends reaching out to your doctor. The proper testing and follow up care with a neurologist could result in positive changes to your long-term health.