How to recognize a ministroke or stroke — and what to do – Harvard Health Blog
If you suddenly experience a strange but fleeting symptom – your arm or face is suddenly weak or numb – you might be tempted to eliminate it, especially if it is short-lived.
But if these strange, unexplained symptoms last more than a few seconds, they could signal a transient ischemic attack, or TIA. Commonly known as a mini stroke, a TIA is caused by a temporary lack of blood in part of the brain. Most of the time, a blood clot is to blame and symptoms go away quickly because your body’s natural clot dissolving action restores blood flow. But according to the American Stroke Association (ASA), these events should be called warning strokes rather than mini strokes.
“A TIA can be the harbinger of a much more serious stroke,” says Dr. Christopher Anderson, director of acute stroke services at Massachusetts General Hospital, affiliated with Harvard. If a blood clot blocking a cerebral artery does not dissolve and stays in place for more than a few minutes, it can destroy brain cells by depriving them of oxygen and nutrients. Known as ischemic stroke, they account for 87% of all strokes. Up to 17% of people with TIA will have a full-blown ischemic stroke within the next 90 days, with the greatest risk in the first week.
What should you understand about TIAs?
A recent study found that women with short-lived sensory or visual symptoms were less likely to be diagnosed with TIA than men. One reason could be that migraines are more common in women. As a result, both women and doctors may be less likely to suspect TIA in women with sensory or visual changes, which can occur with or without a migraine. “But it’s important to consider TIA in all people with these symptoms, regardless of gender,” says Dr. Anderson.
Other symptoms of short-lived TIA can be easy to ignore, says Dr. Anderson. “Sometimes people say, ‘It’s funny, I can’t feel one side of my face’ and scramble their words for a short period of time,” he says. People may drop objects repeatedly (a kitchen utensil, for example) but be able to function normally after a few minutes. Another classic symptom of TIA is seeing what is often described as a dark curtain falling over an eye from top to bottom. This symptom is called amaurosis fugax (from the Greek amaurosis, meaning dark, and Latin fugax, meaning ephemeral).
BE-FAST when recognizing a stroke or TIA
The ASA invented the mnemonic FAST to help people recognize the symptoms of stroke. The first three letters, which represent Fhave fallen, Arm weakness, and Speech difficulties) account for about 75% of the symptoms people experience during a stroke. (The T stands for Time to call 911.)
But some neurologists suggest adding two more letters: B for balance and E for eyes. Balance is a tricky issue, as balance issues can arise due to a range of issues other than a stroke, especially in older people, Dr. Anderson explains. With stroke, balance problems rarely appear in isolation; they usually occur in tandem with other symptoms such as weakness in the legs or vision problems, he explains. Vision problems during a TIA or stroke can include reduced, blurred, or double vision.
The simpler FAST makes sense for a public health campaign. But if you are at risk, knowing about BE-FAST may be most helpful, as it can help you recognize even more potential TIA and stroke. High blood pressure is the main cause of stroke. Other risk factors to consider include smoking, diabetes, physical activity and obesity. People with heart disease (such as coronary artery disease, atrial fibrillation, and heart failure) have a higher than normal risk of stroke. Talk to your doctor about your risk for stroke or TIA and the healthy steps you can take to lower your risk of having either.
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