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Many Patients Often Miss Signs of Minor Strokes, Fail to Get Care


Would you notice the signs your were having a minor stroke? As many as 70% of people who have a minor stroke don’t which leads to a delay in seeking medical care.

A British study conduced by Arvind Chandratheva, a clinical research fellow in the Stroke Prevention Research Unit in the Department of Clinical Neurology at the University of Oxford in the United Kingdom, and colleagues noted more than two-thirds of patients were unaware they suffered a minor stroke and almost one-third delayed seeking medical attention for more than 24 hours.

The researchers have published their findings in the April 15 issue of Stroke: Journal of the American Heart Association. The study analyzed 1,000 patients in the United Kingdom (average age 73), of whom 459 had transient ischemic attacks (TIAs) and 541 suffered a minor stroke.

Looking at patients’ behaviors and attitudes, the researchers found the participants frequently failed to recognize when they were having a minor stroke and therefore failed to seek immediate medical care. This was surprisingly true of people of all demographics — regardless of age, gender, education and socioeconomic status.

A minor stroke is defined as minimal deficits based on the NIH Stroke scale assessing consciousness, vision, sensation, movement, speech and language.

TIA (transient ischemic attack), sometimes known as a “mini stroke,” occurs when a blood clot temporarily clogs an artery and blocks blood flow to the brain.

TIAs and minor strokes don’t typically cause permanent harm, but early treatment is critical to prevent the possibility of a stroke with permanent neurological deficits.

Researchers, investigating factors that cause delays in seeking timely treatment, found that:

  • 68% of TIA patients and 69% of minor stroke patients didn’t recognize the cause of their symptoms.
  • Only 47% of TIA patients and 46% of minor stroke patients sought medical attention within three hours. Clot-busting drugs must be given within this time frame to reverse the stroke and minimize damage.
  • 67% of TIA patients and 74% of minor stroke patients sought medical attention within 24 hours. Those who didn’t correctly recognize their symptoms were less likely to call emergency services.
  • 77% of patients went to their primary care physicians first instead of seeking emergency medical care.
  • 30% of patients experiencing a recurrent stroke didn’t seek timely medical attention.

If motor or speech function were affected, TIA patients were more likely seek medical care. Failure to seek medical care was more likely if their motor or speech function were normal, if symptoms didn’t last long, or if they experienced symptoms on a Friday, a weekend or a holiday.

In the United States, stroke is the No. 3 killer and a leading cause of long-term severe disability, according to American Heart Association statistics. About 15% of major strokes are preceded by a TIA.

It is important to seek immediate medical care if you experience any of the warning signs of a stroke. Don’t wait to see if they will “get better.” The warning signs of stroke are:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

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It is important to seek immediate medical care if you

Many patients don't know they had minor stroke, need emergency care; Stroke April 2010; Arvind Chandratheva BM, MRCP; Daniel S. Lasserson, M.A., M.B.B.S.; Olivia C. Geraghty, M.R.C.P; and Peter M. Rothwell, M.D., Ph.D.