TIAs, Or A Stroke? What Do I Do?
TIA’s or a Stroke?
There is a lot of confusion about TIAs (Transient Ischemic Attacks) and strokes, at least from what I hear. You know, people get together and talk about their own and everyone else’s ailments? I hear things which are actually medically impossible. I think some of the confusion about strokes and TIA’s arises because the term “mini-stroke” is popularly used to describe what is really a TIA.
My mom has frequent TIAs. Usually, they are brief and the aftereffects short-lived. By now she’s had so many, her symptoms linger for days or weeks before they resolve. With each new one she loses just a bit more function that doesn’t come back. She has actually never had a full stroke.
What is a TIA?
“A transient ischemic attack (TIA) is a stroke lasts only a few minutes. It happens when the blood supply to part of the brain is briefly blocked. Symptoms of TIAs are like other stroke symptoms, but do not last as long. They happen suddenly, and include
- Numbness or weakness, especially on one side of the body
- Confusion or trouble speaking or understanding speech
- Trouble seeing in one or both eyes
- Difficulty walking
- Loss of balance or coordination
Most symptoms of TIAs disappear within an hour, although they may last for up to 24 hours. Because you cannot tell if these symptoms are from a TIA or a stroke, you should go to the hospital right away.” https://medlineplus.gov/transientischemicattack.html
I suspect Mom’s had a TIA in the last 48 hours based on her history. She a harder time sitting up in a chair. She leans to the right and has to be propped up with pillows to sit. She has more choking spells, difficulty holding a cup, increased weakness and confusion. She is past the point that we would do aggressive medical treatment, but if my husband or I showed those symptoms, you’d better believe I’d be calling 911.
Usually, TIA’s are a warning sign for future stokes. One in three people who have a TIA will go on to have a full-blown stroke. On a couple of occasions, I’ve was sure Mom is having a stroke, but her MRI’s were negative, but showed changes consistent with multiple TIAs.
Why Is It Important?
Why is it important? If you can’t tell if you are having a TIA or a stroke, it’s best to go to the hospital right away. If caught soon enough, the effects of a stroke can be mitigated and permanent damage avoided. Strokes are now the leading cause of death in the U.S. according to the American Heart Association.
When a stroke occurs, time is of the essence. You need to act fast to hopefully prevent permanent damage and disability. The American Stroke Association together with the American Heart Association have come up with the acronym, F.A.S.T., to help you recognize and remember signs of a stroke.
F.A.S.T. stands for:
- Face drooping—Can the person smile normally, or does one side of the face droop?
- Arm weakness—When the person raises both arms, does one drift downward?
- Speech difficulty—Can the person speak normally, or is speech slurred?
- Time to call 911—If you see or experience any of these symptoms, call 911 immediately.
A person does not have to be experiencing all these symptoms to be having a stroke. Any one symptom is enough to call 911 immediately. The faster treatment can be started, the better.”
Here’s a humorous and musical look at FAST.
Say Something, or Not?
Years ago, I was in a fast food restaurant with my kids. A lady and her elderly mother were at a nearby table. From their conversation I gathered they’d just been to the doctor. (Not that I would ever eavesdrop.) As they chatted, the older woman suddenly fell on the floor. It wasn’t a gradual fall, it was–one minute she was sitting–the next she wasn’t. She was obviously embarrassed. Her daughter helped her up and determined she was not hurt. I knew a sudden fall from a chair like that, is often a warning sign of an impending stroke. One side has sudden weakness, your balance is off and you tip to the weak side.
I dithered about whether to say something to them or mind my business. I reasoned, they’ve obviously just come from the doctor so I know they’re watching her. Then I leaned the other way, thinking, but I work on an acute stroke unit. I know the signs. I should tell her–but would she believe a young woman with a brood of kids in tow? I was in casual clothes. I didn’t look very authoritative.
In the end, I didn’t say anything. A kid distraction occupied me and by the time I’d dealt with it, the ladies were gone. To this day I wonder if she was OK. I wasn’t a hero like the people in the video. 🙁
Stroke in Young Adults
Not only the elderly have strokes. There are different types of strokes. In those under 45, the cause is often a tear in a blood vessel in the neck (dissecting aneurysm). Different studies vary but stokes occurring in younger adults account for 10-15% of all strokes. The economic impact of a young person with a stroke is enormous. Think of a young mother unable to care for her children or work, or a young man unable to provide for his family for an extended period.
Below is a video showing of the evolution of a TIA. Unfortunately, the site doesn’t allow embedding. Hit the arrow on the right to show the evolution sequence.
Below is a video animation of a stroke. It’s silent, so there’s nothing wrong with your speakers.
I’d be remiss if I didn’t at least mention prevention, though I’m sure you’ve heard it. Control your weight and blood pressure. If you’re on blood pressure medication, TAKE IT! It drives me crazy when people say they’ve stopped taking their meds because, “I think it gives me headaches, it’s too expensive, I don’t have time to pick up the refills, or (fill in the blank).” I’ve seen the results of not taking your meds and there is no excuse you can give me that makes it worth it. (OK, I’ll step away from my soapbox.)
Keep your cholesterol in check. Don’t smoke or do drugs. Limit alcohol intake. Exercise regularly. Eat lots of fruits and vegetables, go easy on red meat, full-fat dairy and saturated fats. Dial back on the salt and sugar. You know the drill.
Take care of yourself and best wishes in your caregiving work. You do a good thing in taking care of your loved one.