DEAR DOCTOR K: My husband's doctor said that he had a ministroke. What does this mean?
DEAR READER: Most strokes occur when blood flow to a part of the brain is blocked. These are called ischemic strokes. When the flow of blood is blocked badly enough, for a long enough time, brain cells die.
Not all blockages of the brain's blood vessels are bad enough, or last long enough, to cause death of brain cells. Instead, the part of the brain that isn't getting enough blood temporarily malfunctions. Such temporary blockages that do not lead to brain-cell death are called ministrokes, the technical term for which is "transient ischemic attack," or TIA.
TIAs usually last several minutes to hours. Below I list the symptoms of both a full stroke and a ministroke. The main difference is that the symptoms of ministrokes are temporary.
If the blockage and the symptoms are temporary, why is it important for you to know about TIAs? Because they greatly raise the risk that a bigger, permanent stroke may be on the way. And also because medical care can reduce your risk of having that stroke.
For that reason, a TIA should be regarded and treated every bit as seriously as a full-blown stroke. It's a warning sign, and unfortunately many people don't get a warning sign before a stroke: They just suddenly have a stroke and suffer permanent brain damage. So if a person is lucky enough to get a warning sign, he or she needs to act on it.
Now that your husband has had a TIA, he might well need drugs to prevent clotting and to lower blood pressure and cholesterol. These help prevent a full-blown stroke.
If he hasn't already, your husband also may need a magnetic resonance imaging (MRI) study. If he is found to be at high risk for an impending stroke, he should be hospitalized right away.
Because of his increased risk, you should be on the lookout for the warning signs and symptoms of another ministroke or of a full-blown stroke. If you observe any of the following, immediately dial 911 or take him to an emergency room:
- weakness in an arm, hand or leg;
- numbness on one side of the body;
- sudden dimness or loss of vision, particularly in one eye;
- sudden difficulty speaking;
- inability to understand what someone is saying;
- dizziness or loss of balance;
- sudden, lasting, excruciating headache.
We have a lot more information on stroke in our Special Health Report, "Stroke: Preventing and Treating 'Brain Attack.'" You can find out more about it at my website, www.AskDoctorK.com.
It's impossible to overstate the importance of acting quickly to prevent a full stroke, if a person has a ministroke. We don't get a lot of second chances in life, but having a TIA and doing something about it is one example where we do.
Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.
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