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Clinical Articles, News & Views

‘Mini stroke’ can cause major disability, may warrant thrombolitics

Transient ischaemic attack (TIA) can lead to serious disability, but is frequently deemed by doctors too mild to treat, according to a study1 in the American Heart Association journal Stroke.

Among the 499 patients studied, 15% had at least minor disability 90 days after their original “mini stroke.” Minor disability was defined as being unable to carry out previous activities, but capable of and handling personal affairs without assistance.

Computed tomography (CT) scans showed some “mini stroke” patients had narrowed blood vessels in the brain, and others reported ongoing or worsening symptoms. Those patients were more than twice as likely to have disability at 90 days. Coutts suggests that thrombolysis treatment should be considered in these patients.

Patients with type 2 diabetes had a similarly high risk of disability. Also, women were nearly twice as likely as men to be disabled 90 days after TIA.

“Our study shows that TIA and minor stroke patients are at significant risk of disability and need early assessment and treatment,” said Dr Shelagh Coutts, lead author of the study (Foothills Hospital, Canada). “We should be imaging patients earlier and be more aggressive in treating patients with thrombolysis if we can see a blockage no matter how minor the symptoms are”.

“For every second after a mini stroke, the patient’s brain may be losing oxygen – possibly leading to a major event,” Dr Coutts said. “If a scan finds that you have a narrowing of a blood vessel in or outside of the brain, you are at a high risk of being disabled.”

Recurrent strokes posed the greatest threat to patients. Of those who had recurrent strokes, 53% were disabled, compared to 12% of patients without a recurrent stroke.

References

1. Coutts SB, Modi J, Patel SK, et al. What causes disability after transient ischemic attack and minor stroke? Stroke 2012;43. http://dx.doi.org/10.1161/STROKEAHA.112.665141

Published on: September 27, 2012

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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