What to Know About Mini Strokes

What is a mini stroke?

A mini stroke may also be referred to as a Transient Ischemic Attack (TIA). This occurs when a patient experiences a temporary period of lack of blood flow to the brain, spinal cord or retina. “Sometimes clinicians prefer to call it a mini stroke to remind the patient that you are not out of the woods and you did in fact suffer a sort of stroke,” explains Dr. Reza Bavarsad Shahripour, a board-certified vascular neurologist and neurosonologist at Providence Saint John’s Health Center in Santa Monica, California.

The symptoms of a mini stroke are typically temporary, and can last anywhere from several minutes to 24 hours. Because of this timing, mini strokes may not be taken as seriously as regular strokes, however, the American Stroke Association warns that a mini stroke can serve as a warning sign that a full-blown stroke may be ahead. In fact, estimates indicate that approximately 1 in 3 people who experience a mini stroke will go on to have a stroke, with around 50 percent of these occurring within a year following the TIA.

A mini stroke vs. a major stroke

Since a TIA is a brief interruption of blood flow, the symptoms typically resolve themselves without materially damaging brain cells or causing a permanent disability. Strokes, on the other hand, typically cause damage to whatever area of the brain they occur in. This can potentially cause more permanent or lasting disabilities like visual impairments, cognitive difficulties, left or right side paralysis, memory loss, speech issues and in extreme cases, death.

Symptoms of a mini stroke

The American Stroke Association notes that anyone can have a mini stroke, but the risk generally increases with age. Mini strokes are typically more common in people over 55, in individuals of south Asian, African or Caribbean descent, and in people with other existing health conditions like diabetes. Being overweight, eating a diet high in salt and fat and smoking or drinking alcohol can also put you at a higher risk of TIA. For patients who have already experienced a stroke, a TIA can sometimes signal a second stroke in the future. Thus, it’s especially important for this population to familiarize themselves with the signs of a TIA.

“Mini stroke patients may present with all of the symptoms that they would experience with an acute large stroke which could be speech difficulty, vision problems, double vision, ataxia, balance problems, weakness or numbness on the face or on one side of the body or sometimes just present with confusion or word finding difficulty where the patient is unable to speak well,” Bavarsad Shahripour explains. Severe headaches without an apparent cause can also be a warning sign of mini strokes.

Bavarsad Shahripour stresses that if you experience symptoms like weakness, numbness, double vision or balance issues that come on suddenly, no matter the duration of time they are experienced, you should to call 911 or have someone safely transport you to the ER for evaluation. “You will then undergo a brain CT scan and CT angiography of the head and neck to be sure there is no narrowing or blockages of the carotid arteries,” Bavarsad Shahripour says. Heart monitoring, he notes, will typically also continue for at least 24 hours during hospitalization, and sometimes the patient will need intervention if they have any critical narrowing in the vessels.

What happens after a mini stroke?

“Mini stroke or TIA usually have a good recovery in the first 24 hours and the patient does not have any more symptoms or deficit, but the patient is not out of the woods,” says Bavarsad Shahripour.  In the first couple of weeks and months after suffering the mini stroke, he says, a patient is often at an elevated risk of having an acute stroke and generally needs to be closely monitored by their vascular neurologist, primary care physician and family at home.

“Studies show that controlling the risk factors and changing the lifestyle and diet significantly decreases the risk of recurrence of strokes and mini strokes/TIA in the first 1-5 years after stroke,” Bavarsad Shahripour adds. Preventing mini strokes, he explains, is essentially similar to preventing other types of strokes. “This includes controlling risk factors such as blood pressure hypercholesterolemia/hyperlipidemia/controlling diabetes and A1c, and other cerebrovascular and cardiovascular risk factors, changing the diet and lifestyle,” says Bavarsad Shahripour.

If you experience symptoms of a mini stroke that pass, you should still seek immediate medical attention. Immediate treatment for mini strokes may include medications to help reduce blood vessel clots as well as minimally invasive procedures that can allow doctors to remove a clot and restore blood flow to the brain.

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