Mini-stroke may be sign of major underlying health issue
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.