How to recognize and what to do in a “warning” stroke

A transient ischemic attack can be a precursor to a future stroke with similar symptoms but permanent disability.

A temporary interruption of blood flow to the brain, known as a transient ischemic attack, can cause a range of distressing symptoms, including difficulty speaking or arm weakness.

Symptoms appear suddenly but usually last less than five minutes, so these episodes are often overlooked.

Although ischemic strokes are often called “mini-strokes,” the term “warning stroke” is actually more accurate. A transient ischemic attack can be a precursor to a future stroke that has similar symptoms but can cause permanent disability.

According to the American Heart Association, about one in five people with a suspected TIA will have a full-blown stroke within three months. Harvard-affiliated Massachusetts General Hospital stroke neurologist Dr. Erica Camargo Faye says the risk of stroke is highest in the first 48 hours after a stroke.

Sometimes what appears to be a transient ischemic attack is more serious than it appears.

“Even symptoms that disappear may actually be a stroke,” says the neurologist.

According to the American Heart Association, two out of five people who have a suspected TIA and undergo an appropriate brain scan learn that they are actually having a stroke. That’s why it’s so important to know the symptoms and seek emergency care right away.

Ischemic or stroke symptoms

Each area of ​​the brain has different tasks, so the symptoms that occur during an episode depend on the part of the brain where blood flow is impaired. Here are some details about each symptom.

Balance. This symptom can be confusing because there are many things that can cause dizziness or balance problems, such as low blood sugar or inner ear problems. Dr. Camargo Faye says balance problems caused by a TIA often make it difficult for a person to stand up and may fall to the side. This symptom is often accompanied by other symptoms, including speech or vision problems, he adds.

Eyes. Vision problems can manifest in a variety of ways, although the most common is a lack of vision in one or both eyes. Often people describe the experience as seeing a dark gray shadow that partially or completely blocks their vision. You may see everything blurry or you may develop diplopia (seeing everything twice).

face During an episode, the face may be pulled to one or both sides. Usually, the corner of the mouth seems to droop and the person is unable to smile. Lowering of the eyes and forehead is less common.

Weakness of arms or legs. This symptom affects the arms more than the legs and usually occurs on only one side. People may describe the sensation as numbness or tingling rather than weakness. Sometimes the whole body is affected.

Difficulty speaking. Slurred speech and difficulty in articulation are the most common occurrences. However, in some cases, people have difficulty finding words or cannot understand what others are saying. This vulnerability also applies to writing and typing, including texting on a smartphone. “The problem is not physical function, but rather a difficulty caused by a lack of blood flow to the areas of the brain that control language,” explains the neurologist.

Time is critical

Experts emphasize that even if the symptoms subside or disappear, the patient should go to the hospital as soon as possible. After the necessary tests, if the patient is found to have a transient ischemic attack, he should undergo further tests to be able to follow certain treatments to prevent future strokes.

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