TIA (Mini Stroke) Symptoms: A Trip to the ER (cont.)

Assessing whether the patient is alert and oriented.

  • Checking vision and eye movements.
  • Looking for weakness in facial muscles.
  • Testing power and sensation of all extremities.
  • Looking for alteration in balance and coordination.
  • Checking speech, recognition, and reading.

In most Emergency Departments, if there is concern for continued stroke symptoms, a standardized assessment will be done, often using the National Institute of Health Stroke Scale.

The doctor also may listen to the neck for bruits, or abnormal sounds, made by narrowing of the carotid arteries causing decreased blood flow. The heart is often checked to look for the irregular pulse of atrial fibrillation. The rest of the physical examination is performed to look for other medical conditions that may contribute to a stroke or TIA.

What is the treatment for a TIA?

The woman and her husband are worried that another TIA will occur, and the doctor advises them that the initial treatment is to take an aspirin a day. The doctor reminds the couple that the risk of stroke in the next few weeks is high and that they should not hesitate to come in at any time for care and evaluation. They should think of a TIA as angina of the brain, in which it is a warning sign of an impending closure of a blood vessel and should not be ignored or taken lightly. The doctor reminds them that taking steps to minimize risk factors for stroke will make a big difference.

Prevention is the best way to treat heart and brain blood vessel narrowing. That includes minimizing the risks as listed above. Aspirin is the drug of choice for TIA prevention, by making platelets less sticky and less prone to get stuck in the narrowed blood vessels of the brain. Those who suffer a TIA while taking aspirin will be offered another type of antiplatelet drug like clopidogrel bisulfate (Plavix) or aspirin/dipyridamole ER (Aggrenox).

What is the prognosis for TIA?

Unfortunately, the risk of stroke after TIA is very high. Ten percent of people with TIAs will have a stroke within three months. The purpose of accessing medical care is to help minimize risk factors to help decrease that 10% risk. Studies published in 2007 suggested that if blood pressure is tightly controlled, cholesterol levels brought down with medication, and smoking cessation is begun, the risk of future stroke can be cut to 2%.

Last Editorial Review: 11/9/2007