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A transient ischemic attack, or TIA, is often called a “mini-stroke,” but it would perhaps be better characterized as a “warning stroke,”—a warning of possible future stroke that you should take very seriously. A stroke occurs when blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes of blockage, brain cells begin to die, causing severe, lasting damage such as partial paralysis, loss of sensation, or inability to speak. Blood supply can be limited secondary to a blockage of the blood vessels, which is referred to as an ischemic stroke, or secondary to a rupture or leak of a blood vessel, which is referred to as a hemorrhagic stroke. If symptoms of the stroke resolve within 24 hours, it is referred to as a transient ischemic attack (TIA). If symptoms persist more than 24 hours, it is diagnosed as a stroke. TIA is caused by a clot; the only difference between a stroke and TIA is that with TIA the blockage is transient, or temporary. In comparison to stroke, TIA symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes; the average is about a minute. When a TIA is over, it usually causes no permanent injury to the brain.
Blood clots may develop for a number of reasons, some common reasons include:
More rare causes of blood clots include:
After a TIA, up to 10 out of 100 people will have astroke in the next two days. And up to 17 out of 100 people will have a stroke within 90 days. And 1 in 3 people who experience TIA go on to have a stroke within a year of the TIA. The risk of stroke is highest in the first 30 days after a TIA. If you or someone you love experiences a TIA, you have a window of opportunity to act, and help keep a permanent stroke from happening. Call 911 or go to the emergency room at your local hospital if any symptoms of TIA or stroke are present! A neurologist can help identify why the TIA occurred and ensure that the proper treatment regimen is put in place—either medication or surgery—that can prevent a stroke from occurring.
A quick acronym to see if you or someone you know has had a stroke is FAST:
T—Time to call 911
The following factors increase your risk of TIA and stroke:
If you are having a TIA or stroke, you or a loved one must call 911 immediately. An emergency team needs to evaluate the type of stroke you’re having and the areas of your brain affected by the stroke. They will need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction.
Your doctor may use several tests to determine your risk of stroke, including:
A TIA is a warning—it means you are likely to have a stroke in the future—or even the near future. 10% of all who have TIA experience a stroke within two days of the TIA. Call 911 immediately if you think that you or someone you know has had a TIA or stroke—early treatment can make all the difference. Symptoms of TIA typically occur suddenly and are always transient, or temporary; and go away within 10 to 20 minutes if not less.
Symptoms of TIA are just like symptoms of a stroke, and vary depending on what part of the brain is affected. These include:
A TIA is often a precursor to stroke—if medical attention is sought immediately after experiencing symptoms of TIA, then there is a much-improved chance of warding of stroke. Stroke is the fourth leading cause of death in the United States. Mortality rates are declining, however. Over 75% of patients survive a first stroke during the first year, and over half survive beyond 5 years. If someone who has had a stroke gets treatment within 3- 4.5 hours from when stroke symptoms first started, rate of recovery are vastly improved.
Improving the overall health of your body and heart can help reduce your risk of future TIA and strokes.
The following are tips for a heart-healthy lifestyle:
Most heart diseases and risk factors contributing to heart diseases are screened for at regular physicals. The American Heart Association stresses the importance of regular screening for cardiovascular disease. American heart association volunteer and director of William Beaumont Hospital in Royal Oak, Michigan, Barry A. Franklin, Ph. D., said on the matter, “Regular cardiovascular screening is important because it helps you detect risk factors in their earliest stages. This way, you can treat the risk factor with lifestyle changes and pharmacotherapies, if appropriate, before it ultimately leads to the development of cardiovascular disease.”
Your doctor will most likely check the following:
If your doctor suspects you have a heart disease after a thorough examination, he or she may conduct several diagnostic tests to arrive at a diagnosis.
Studies show that approximately 80% of strokes are preventable, given that preventative measures are taken early enough. You can help prevent a TIA or stroke if you take care to control key risk factors and treat other medical conditions that can contribute to stroke.
Taking steps towards a heart healthy lifestyle is critical—but it is within your power to take control of these lifestyle changes, and that can be empowering!
Preventative measures against stroke include:
After you’ve suffered a TIA you’ll probably be prescribed several medications to help prevent blood clots that can cause another TIA or stroke. Aspirin is most often used to prevent TIAs and strokes.
The types of medicines that prevent clotting are:
Anticoagulant medicines, or blood thinners. These reduce the chance of your getting clots in your arteries. Some anticoagulants include:
Side effects of anticoagulants include:
*** Because anticoagulants lengthened the time required to form a blood clot, patients taking anticoagulants are at a higher risk for excessive bleeding and hemorrhaging. Speak to your doctor about the risks and benefits of taking anticoagulants. It is especially important to take into consideration this potentially life threatening side effect.
Anti-platelet medicines, which prevent clotting by keeping platelets from sticking together. They include:
Side effects of antiplatelet medications include:
Cholesterol-lowering and blood pressure-lowering medicines are also used to prevent strokes.
Cholesterol-lowering drugs include:
Side effects of cholesterol-lowering drugs include:
Blood pressure medicines include:
Angiotensin II blockers (ARBs)
Side effects of ARBs include:
Angiotensin-converting enzyme (ACE) inhibitors
Side effects of ACE inhibitors include:
Side effects of Beta-blockers include:
Calcium channel blockers
Side effects of calcium channel blockers include:
Side effects of diuretics include:
Complementary and alternative treatments for stroke can help with symptoms, recovery, and prevention, but please be aware that none of these alternative, complementary therapies is a direct treatment for stroke that should take the place of medical therapy. Always check with your cardiologist or primary doctor before adding or changing your regimen for treating and preventing stroke.
Acupuncture. This ancient treatment has been used for centuries in Asian cultures. Tiny needles are inserted painlessly into specific points in the body to help ease pain and treat paralysis and other muscle problems affected by stroke. Acupuncture can help with difficulties with language, paralysis, muscular issues; and is part of stroke treatment in both Japan and China. A similar therapy is acupressure—a type of soft tissue massage. This uses the same points as acupuncture without involving needles.
Dietary Changes. Unhealthy amounts of cholesterol can lead to blood clots and embolism, which can cause stroke. Dietary changes can help prevent TIA or stroke, and can also help you live more healthily when recovering from TIA or stroke. Here are some top tips:
Massage therapy is used for many different conditions; with respect to stroke, it can help alleviate muscular problems by increasing blood flow to affected areas. As well, massage can help by:
Yoga and Tai chi. Yoga and tai chi promote wellness in a number of ways. Both practices promote smooth physical flowing movements and because the exercise has a meditative aspect to it, can help invigorate mental focus that may have been lost due to the stroke. Yoga is also a good option for a low-impact exercise program for continued wellness and can work preventively as well.
Aromatherapy. Certain scents are known to help people relax and relieve pain. Rosemary, lavender, and peppermint are three scents that people who have had strokes use to help with pain, small research studies have shown that when used with acupressure massage, that effects are more impactful than when no aromatherapy is used.
Herbal medicine. Some herbs may help improve blood circulation in the brain and brain function. Some may help protect you against another stroke. Consult your doctor before using any herbs or nutritional supplements, as they may interfere with medication you are already taking. Research has not been conclusive regarding the use of herbal medicines for TIA or stroke. Some herbal medicines that merit deeper study include Ginkgo biloba, Mailuoning, Xuesetong, Ligustrazine, and Acanthopa
Having a TIA can be difficult for you and your family, causing concern for whether a stroke may occur shortly thereafter, but there are things you can do to help keep yourself healthy:
You should not hesitate to call 911 if you are experiencing any of these symptoms that come on suddenly. You could be having a STROKE.
In addition to your primary care physician, you may want to include an internist (specialist in internal medicine), a neurologist (nervous system specialist), a cardiologist (heart specialist) and/or a neurosurgeon (surgeon specializing in brain and spinal cord operations).
You will probably have different questions to ask your doctor depending on your heart condition. Be open about all your concerns. If you’re having difficulty focusing, bring along a friend or family member. Below you’ll find general questions you might want to ask your doctor about heart disease as suggested by the American Heart Association.
QUESTIONS ABOUT MEDICATION
QUESTIONS ABOUT DIET
QUESTIONS ABOUT EXERCISE
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