By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Of all sudden cardiac events, I find strokes the most frightening.
Not only are they deadly– strokes are this country’s fifth leading cause of death (heart disease is the first)—but they can be terribly disabling. Without immediate treatment, it’s not uncommon for stroke survivors to lose speech or motor skills and, along with them, their ability to perform basic day-to-day tasks.
Although there are some tests that can help predict your stroke risk, there is only one genuine warning sign that a stroke is likely in your future: a ministroke. Let’s take a closer look at these events:
- What Ministrokes Are and How to Know if You’re Having One
- Unique Signs and Risk Factors for Women
- The Most Common (and Dangerous) Ministroke Mistake
- Cognitive Damage and Other Ministroke Side Effects
What Are Ministrokes?
Ministrokes—also called transient ischemic attacks (TIAs) or “warning strokes”—are just like regular strokes in that they’re caused by clots that cut off circulation to part of the brain.
The difference between a ministroke and a regular stroke is that a ministroke lasts for only a minute or two, until natural clot-busting agents in the blood dissolve the blockage and symptoms pass.
Ministroke and stroke share the same symptoms, all of which come on suddenly:
- Face, arms, legs (often on one side of the body) become numb, weak or paralyzed
- Speech becomes difficult: slurred, garbled
- Becoming confused or finding it difficult to understanding what others are talking about
- Vision changes, in one or both eyes
- Walking becomes difficult, there’s a loss of balance or coordination
- Becoming dizzy
- Developing a severe headache
Ministrokes (TIAs) Are Often Warnings that “Real” Strokes Are About to Happen
Unique Risks and Signs of Ministroke in Women
Smoking, high blood pressure, atrial fibrillation, and family history are well-known risk factors for both ministrokes and full-blown strokes, across the entire population. However, if you are a woman, you also face some additional risk factors and symptoms. These include—
- Taking birth control pills in combination with older age (35-plus), smoking, or diabetes
- Conventional hormone replacement therapy (HRT)
- History of migraine headaches with aura
Women’s stroke symptoms also can present differently than men’s. In addition to the classic ones I mentioned earlier, other signs of a ministroke in a woman include:
- Loss of consciousness or fainting
- General weakness
- Difficulty breathing or shortness of breath
- Confusion, unresponsiveness or disorientation
- Sudden behavioral change
- Nausea or vomiting
Failure to Act: The Most Common Ministroke Mistake
Because ministrokes come and go so quickly, many people don’t respond to them as they should. Some people never fully realize what’s happening, and instead attribute their symptoms to being overly tired, hungry, or otherwise not feeling well. Others incorrectly assume the danger is past when the episode is past. Worse yet, they may deny that there was ever any danger to begin with.
All of these responses put your health—and potentially your life—at risk.
Anyone experiencing the symptoms of a ministroke should seek treatment at the emergency room immediately—even if those symptoms have passed.
Though you may appear to be fine, you’re not. Ministrokes are warnings that circulation to your brain is significantly compromised, and that you may soon suffer a full-blown stroke. According to National Stroke Association statistics, 40 percent of people who have a ministroke will go on to have the real deal—and almost half of those strokes will occur within a few days of the ministroke.
Seeking immediate treatment can ensure that you receive therapies—such as blood-thinning drugs—that help you avoid a more catastrophic event.
Ministroke Side Effects Can Include Long-Term Cognitive Damage
Early treatment also may help minimize ministroke side effects.
Traditionally, we’ve thought that because ministrokes are transient, they have no lasting effects on the brain. But that may not be true, based on research over the past few years.
Ministrokes have been identified as a common thread in many people with symptoms of dementia.
In 2012, the University of Rochester Medical Center observed that an estimated 55 percent of people with mild dementia, and approximately 70 percent of people with more advanced dementia, had evidence of past ministrokes. Researchers at the institution shared this information along with the results of an animal study indicating that ministrokes affect neuronal activity in the brain for longer than previously thought.
Since then, additional studies have begun looking more closely at the relationship between ministrokes and brain function—and they’re finding that ministroke side effects are real.
A 2014 study published in the journal Stroke compared the cognitive skills of people with a history of ministroke to those of a control group. Researchers found that more than one-third of the participants who’d suffered a ministroke scored lower on at least one of the tests administered. The tests measured memory, attention, and information processing speed.
A second study, this one involving more than 23,000 people enrolled in the REGARDS study, linked stroke symptoms and ministrokes with an increased likelihood of developing memory and thinking problems.
Because the stakes are so high with stroke—both small and large—it’s imperative that you understand the risk factors and symptoms outlined above.
If you experience any of the symptoms in a way that seems unusual to you, seek help immediately. Don’t assume that you are out of the woods simply because the symptoms go away. Instead, acknowledge them as potential signs of a ministroke and take action. It could help save your brain and your life.
- American Academy of Neurology (AAN). “Stroke symptoms associated with developing memory and thinking problems, even without stroke.” ScienceDaily. Last accessed March 11, 2022.
- Centers for Disease Control. Leading Causes of Death. Last accessed March 11, 2022.
- Kelley BJ, et al. Report of stroke-like symptoms predicts incident cognitive impairment in a stroke-free cohort. Neurology. 2013 Jul 9;81(2):113–8.
- National Stroke Association. What Is TIA? Last accessed March 11, 2022.
- National Stroke Association. Women Have a Higher Risk of Stroke. Last accessed March 11, 2022.
- van Rooij FG, et al. Persistent cognitive impairment after transient ischemic attack. Stroke. 2014 Aug;45(8):2270–4.
- University of Rochester Medical Center. “Brain damage triggered by mini-strokes detailed.” ScienceDaily. Last accessed March 11, 2022.
© Stephen Sinatra, MD. All rights reserved.