To Many Ignore Symptoms of Mini Stroke

Only 1 in 10 sought emergency treatment in British study.

By Ed Edelson from the U.S. National Health Information Center

Fewer than half of the people in a new study who felt the symptoms of a "mini-stroke" sought medical attention quickly, and just one in 10 went to an emergency room.
"These figures are a cause for concern," said lead researcher Dr. Matthew F. Giles, a research fellow in clinical neurology at the University of Oxford, England.

According to Giles, these transient ischemic attacks (TIAs) put individuals at high risk of having a major stroke soon afterward. Reporting in the March 31 issue of Stroke , Giles and his colleagues interviewed 241 people who had a TIA, asking them about what they thought was causing their symptoms.

Symptoms typically include:
•Sudden numbness or weakness of part of the body,
• Sudden confusion,
• Visual problems,
• Dizziness or a
• Sudden severe headache.

Just 107 recognized the onset of symptoms as an emergency. Only 27 sought non-emergency treatment the same day; 43 waited until the next day to seek treatment, and 64 delayed two days or more. People who had TIA symptoms on a Friday or Saturday were especially unlikely to seek medical attention the same day.

"That is an example of people not paying heed to these symptoms," Giles said. "If you have a TIA on the weekend, you'll say, 'I'll get in touch with the family doctor on Monday.' But by Monday everything is settled down, and you don't do it."

The nature of the symptoms had a strong influence on an individual's response. People who experienced major motor problems such as weakness in the face, arm or leg were more likely to recognize these symptoms as an emergency. The same was true for those whose symptoms persisted for more than an hour.

A TIA is temporary blockage of a brain artery, particularly common in the elderly. The average age of the people in the study was 71. Prompt treatment of the immediate event and follow-up therapy -- such as lowering cholesterol levels and blood pressure -- can reduce the long-term risk of a major stroke, Giles said.

What was true in the British study holds for the United States, noted Dr. Claudette Brooks, an assistant professor of neurology at West Virginia University and a spokeswoman for the American Heart Association.

"The most important thing to do is education, not only for the population at large but also for people at high risk, such as those with coronary artery disease, high cholesterol or diabetes," Brooks said.

Anyone feeling the symptoms of a TIA should go directly to an emergency room, she advised. "If you call your family doctor, you're wasting time," she said. "If you call your primary-care physician you'll be told to go to an emergency room anyway."

Immediate action is necessary, Brooks said, because after a TIA, "you are at increased risk especially over the next 90 days, but also of having a major stroke in the next 48 hours to seven days."

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