Mini-stroke may be sign of ma­jor un­der­ly­ing health is­sue

The Hazleton Standard-Speaker - - FACTS & FIGURES - Eve Glazier, M.D. Ask the Doc­tors © 2017 UCLA Health Send your ques­tions to ask­the­do­c­tors@med­net.ucla .edu, or write: Ask the Doc­tors, c/o Me­dia Re­la­tions, UCLA Health, 924 West­wood Blvd., Suite 350, Los An­ge­les, CA, 90095.

DEAR DOC­TOR: While my wife and I were work­ing in the gar­den, she got dizzy and couldn’t un­der­stand what I was say­ing. It went away af­ter a few min­utes, but I took her to the ER any­way. The doc­tors said she had a TIA. What is that, and is it dan­ger­ous?

DEAR READER: Your wife ex­pe­ri­enced a tran­sient is­chemic at­tack, or TIA. Also known as a mini-stroke, a TIA hap­pens when part of the brain is tem­po­rar­ily de­prived of blood flow.

You were right to seek im­me­di­ate med­i­cal help. The symp­toms of a TIA and those of a ma­jor stroke, which is the fifth-lead­ing cause of death in the United States, are quite sim­i­lar. And though the ef­fects of a TIA are tem­po­rary — that’s the “tran­sient” in the name — that doesn’t mean they’re harm­less.

First, let’s talk about what’s go­ing on.

Is­chemic strokes oc­cur when a blood ves­sel in the brain be­comes blocked, of­ten by a blood clot. As a re­sult, the part of the brain that is fed by that ves­sel is starved of blood. Since blood car­ries oxy­gen, which is vi­tal to sur­vival, it takes just a few min­utes for brain cells to be­gin to die.

Un­like in a ma­jor is­chemic stroke, where the block­age per­sists and dam­age can be per­ma­nent, a TIA re­solves quickly. Some­times it takes just a few min­utes, and some­times the ef­fects can last up to 24 hours. When the TIA is over, the per­son feels nor­mal again.

Symp­toms of a TIA in­clude the dizzi­ness and cog­ni­tive lapse that your wife ex­pe­ri­enced. Ad­di­tional symp­toms may be a sudden headache, im­paired vi­sion, numb­ness or weak­ness in the face or limbs, gar­bled speech, and loss of bal­ance and co­or­di­na­tion.

The fed­eral Cen­ters for Dis­ease Con­trol and Pre­ven­tion clas­sify a TIA as a med­i­cal emer­gency. Al­though im­pair­ment due to a TIA is tem­po­rary, the event it­self is a warn­ing sign that needs to be ad­dressed. A per­son who has ex­pe­ri­enced a TIA is at in­creased risk of a full­blown stroke, par­tic­u­larly in the first few days af­ter the at­tack. How­ever, with prompt treat­ment, as well as cer­tain life­style changes, you can de­crease the chance of a fu­ture stroke.

Your wife should see her pri­mary care physi­cian to dis­cuss what hap­pened and to be­gin treat­ment. This typi- cally in­cludes tak­ing as­pirin, a blood thin­ner that makes your platelets less likely to clump to­gether. As­pirin should be ini­ti­ated and con­tin­ued un­der a doc­tor’s su­per­vi­sion.

The good news is that your wife can also make some sim­ple life­style changes to de­crease her risk of another episode:

■ Keep blood pres­sure un­der con­trol.

■ Don’t smoke, and avoid sec­ond­hand smoke.

■ Main­tain a healthy weight.

■ Eat plenty of fresh fruits and veg­eta­bles.

■ Ex­er­cise reg­u­larly.

■ Avoid stress. ■ Get enough sleep.

■ Limit al­co­hol. Even bet­ter news: Ev­ery one of these sug­ges­tions will make you health­ier, too.

Eve Glazier, M.D., MBA, is an in­ternist and as­sis­tant pro­fes­sor of medicine at UCLA Health. El­iz­a­beth Ko, M.D., is an in­ternist and pri­mary care physi­cian at UCLA Health.

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