Doctors: ‘Mini-strokes’ can lead to serious problems - Valley Morning Star : Local News

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Doctors: ‘Mini-strokes’ can lead to serious problems

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Posted: Sunday, September 22, 2013 9:01 pm

HARLINGEN — Medical experts say that, while fleeting, Transient Ischemic Attacks — also known as “mini-strokes” or TIAs — can be a warning of serious health issues that could lead to more severe stroke.

Dr. Wondwossen Tekle, an endovascular neurologist at Valley Baptist Medical Center in Harlingen, gave a presentation at the hospital this week for about 100 area residents.

His advice to them was clear and urgent: If you have TIA or stroke symptoms, get to a hospital immediately.

TIAs are caused by temporary clots with sudden symptoms, and last a relatively short time, according to the American Stroke Association.

The symptoms can include difficulty when speaking, weakness in the extremities and sagging of the facial muscles.

It can be difficult to differentiate a stroke from a TIA at the time of an attack, Tekle said, and time is crucial to treatment.

In addition, immediate examination following a TIA can help physicians prevent a more severe stroke by treating the underlying causes of the event.

“TIAs are true medical emergencies. The risk of stroke, disabling or deadly stroke, in the next few months is as high as 15 percent, based on different studies,” he said.

“Of those 15 percent of patients, half of them will have a stroke within the next 48 hours. In fact studies say that from patients that come in with a stroke, up to 41 percent of them had warnings, TIAs, in the last 30 days — most of them within the last week,” Tekle said.

People can identify and deal with TIA symptoms with a technique known as “FAST”: F-ace drooping, A-rm weakness, S-peech difficulty, and T-ime to call 911, according to the American Stroke Association website.

Experts say it is critical that people who experience TIA symptoms go immediately to the hospital — even if those symptoms fade or go away completely — so doctors can identify the root cause of the TIA and address any other existing or underlying health factors.

Tekle said the TIA definition has been refined over the past several years. Previously, physicians classified them based on the duration of symptoms, rather than on the lasting effect on the brain, as it is classified now.

While the definition of a TIA was changed in 2009 by the American Stroke Association, Tekle said, many physicians and even the World Health Organization have lagged in adopting the new definition.

“With the development of all the MRIs and all the neuron-imaging technologies, the old definition of TIAs is kind of obsolete now,” he said.

“The old definition of TIAs is basically time-based. They basically looked at symptoms of an acute neurovascular event which lasted for 24 hours or less. Over the years, it has been changed from 24 hours to less than one hour.”

Many patients previously thought to have had TIAs under the old definition showed MRI changes consistent with acute stroke, rather than with no changes whatsoever.

Now, physicians define TIAs as neurological events that do not result in neuron death, unlike more severe strokes, he said.

“With the advent of this technology, we should move from a time-based window to an imaging-based window,” Tekle said.

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