Stroke symptoms need emergency treatment even if they disappear quickly

Credit: Mat Napo / Unsplash.

In a report from the American Heart Association, scientists suggest stroke symptoms that vanish in less than an hour still require emergency medical assessments to prevent a full-blown stroke.

The scientific statement offers guidance for evaluating suspected “warning strokes” – called transient ischemic attacks, or TIAs.

A TIA occurs when blood flow to the brain is temporarily blocked.

A TIA does not cause permanent damage. However, up to 18% of people who experience a TIA will have a larger stroke within three months – and half of those strokes will occur within two days.

TIA symptoms are the same as stroke symptoms, but they happen suddenly and fade quickly, typically in under an hour.

Symptoms may include facial drooping, weakness or numbness on one side of the body, slurred speech or difficulty finding the right words, dizziness, vision loss, or trouble walking.

In the new statement, the researchers offer guidance on how to distinguish between a TIA and a “TIA mimic,” conditions that produce similar symptoms but are due to other medical conditions, such as low blood sugar, a seizure, or migraine.

In a TIA mimic, symptoms can spread to other parts of the body or build in intensity rather than dissipate.

The team says bloodwork should be done in the emergency room to rule out other conditions that can produce TIA symptoms, such as infections, and to check for cardiovascular risk factors such as diabetes and high cholesterol.

People with heart risk factors are at higher risk for TIAs, as are those with obstructive sleep apnea, peripheral artery disease, atrial fibrillation, coronary artery disease, and a history of stroke.

After assessing a person’s symptoms and medical history, ER staff should do imaging tests of the blood vessels in the head and neck, starting with a non-contrast head CT to rule out intracerebral hemorrhage and TIA mimics.

A CT angiography, which looks for signs of narrowing in the arteries leading to the brain, also may be done.

Nearly half of the people who have TIA symptoms will show signs of narrowing in these arteries.

Brain injury – a sign that a full-blown stroke occurred – can be ruled out using magnetic resonance imaging, or MRI, which should ideally be done within 24 hours of symptoms appearing.

About 40% of people who go to an ER with TIA symptoms are diagnosed as having a stroke based on an MRI.

But some hospitals may not have access to MRI scanners in their emergency departments and will have to admit the patient or send them to another facility.

After a TIA is diagnosed, the patient should be given a cardiac workup to identify heart-related factors.

This should ideally be done in the emergency department but can be done during a follow-up visit with a specialist, preferably within a week of the TIA, according to the statement.

If you care about stroke, please read studies that repairing the gut may save brain function after stroke, and better high blood pressure treatment for stroke patients.

For more information about stroke, please see recent studies about how the Mediterranean diet could protect your brain health, and the MIND diet could slow down cognitive decline after stroke.

The study was conducted by Dr. Hardik P. Amin et al and published in the AHA journal Stroke.

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