Mini-stroke: warning that major stroke is near

Mini-strokes lead to a major stroke within one week in 1 out of 20 people and should be treated as a medical emergency, British doctors said on Sunday.

They said patients who are immediately treated for small strokes, called transient ischemic attacks (TIAs) had almost no risk of a major stroke soon afterward.

But people who did nothing about a TIA had an 11-percent risk of a major stroke within one week, Dr. Matthew Giles and Peter Rothwell of the Stroke Prevention Research Unit at the University of Oxford reported.

TIAs are smaller versions of major strokes and cause similar symptoms such as dizziness, weakness of an arm or leg or visual disturbances. The symptoms are usually mild and transient, so it’s easy for people to ignore these episodes. However, TIAs are a warning sign that a larger stroke may be on the way that can cause paralysis, loss of speech, cognitive confusion or death.

For their study, published in the Lancet Neurology, Giles and Rothwell combined results from 18 different groups of patients, a total of more than 10,000 people.

Overall, 5 percent of patients had a major stroke within seven days of a TIA, they found.

Less than 1 percent of patients treated for a TIA at a specialist neurology clinic went on to have a major stroke within a week, compared with 11 percent of those who ignored the TIA, they found.

“The risk of stroke reported amongst patients treated urgently in specialist units was substantially lower than risks reported among other patients treated in alternative settings,” they wrote.

“These results support the argument that a TIA is a medical emergency and that urgent treatment in specialist units may reduce the risk of subsequent stroke.”

Most strokes are caused by a blockage to one of the arteries in or leading to the brain. A small percentage of strokes are hemorrhagic, caused when a blood vessel blows out.

More than two thirds of major stroke survivors have some type of disability.

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