One of my friends has had a number of ministrokes.
As we sat down for lunch he told us that the previous problems, which we had
attributed to mixing medication and booze, was in fact due to a miinistroke. He said
the Doctor told him that he had a mini-stroke, or a Transient Ischemic Attack
(TIA) as the Doctors call it, and so he was not too concerned. This is the
third mini stroke that he has had in the past two years.
A
Transient-Ischemic Attack or “mini-stroke” is when a blood clot stops
blood from flowing to the brain for a short time. Effects are
short-term, or transient. The brain returns to normal.
I am worried about my friend because the stats
are not good: More than 1/3 of people who have a TIA are expected to eventually
suffer a stroke although studies may vary, up to 20% of these people will
suffer a stroke within 90 days.
What happens in a TIA?
Part of the brain can not receive blood
anymore, so it becomes starved of oxygen and nutrients. This is called ischemia. It caused my friends’ abnormal
behaviours.
The brain needs blood to survive as blood
contains oxygen and nutrients needed by the brain. Th blood flows from the
heart, up through lots of arteries, which branch out into the brain.
How a blood clot can form
Over many years, fat and cholesterol in the
blood can stick to the artery wall, gradually building into a plaque. The artery
becomes increasingly stiff and narrow This process is called atherosclerosis. Part
of the plaque can break off forming a blood clot, this blood clot flows through
the artery towards the brain, where it gets stuck in one of the smaller
arteries.
As part of the brain cannot receive blood anymore, so it becomes starved of
oxygen and nutrients. This is called ischemia. This is what caused my friend`s abnormal behavior’s. For my friend the world flipped upside down,
and everything he saw was upside down. It took a few minutes for his world to
right itself, but when it did, he did not go seek medical help. He continued on
as normal. It was only at his next regular visit to his doctor that he told the
her about this event. He was tested and it was determined that he had a stroke.
What should you do if you suffer a mini-stroke
Never drive yourself or the person having a
stroke or TIA to the hospital. CALL AN AMBULANCE. Ask to be taken to the closest hospital that
provides expert stroke care. You should be seen quickly after arriving at the
hospital. If possible you should receive a brain scan to find out if your
symptoms were caused by a blood clot or bleeding into your brain.
Who is at risk factors for a mini-stroke?
Here are risk factors
cannot be controlled:
·
Age – most occur over age 65
·
Gender – after menopause women have a
higher risk than men
·
Ethnicity – First Nations, African,
Southeast Asian
·
Family history – higher if others in
the family have experienced TIAs or strokes
·
History of stroke or TIA – you have
had a previous incident
Risk factors you can do something about:
·
High blood pressure (hypertension)
·
High blood cholesterol
·
Heart disease atrial fibrillation
·
Diabetes
·
Being overweight
·
Excessive alcohol consumption
·
Physical inactivity
·
Smoking
·
Stress
Like my friend, the symptoms and signs of a
TIA will have gone away by the time you get to the hospital or see your doctor,
so the TIA diagnosis may be made based on your medical history alone.
If you have had a TIA within the last 48
hours, you will likely be admitted to the hospital so that doctors can search
for the cause and observe you.
A
complete neurological examination involves testing your language and memory
skills; your behaviour, alertness, vision, and eye movements; your muscle
control; your ability to walk (gait); and your sense of touch.
An abnormal sound called a bruit may be heard
when listening to the carotid artery in the neck or other artery. A bruit is
caused by irregular blood flow which could mean a blockage in the artery
Blood tests are done to learn whether there is
anything in your blood that would tell your doctor what caused your TIA. Your
blood may be tested for cholesterol and triglyceride levels, blood sugar level,
and abnormalities in blood clotting.
The good news for my friend is that TIAs do
not cause lasting damage to the brain. However, they are a warning sign that he
may have a true stroke someday. He can reduce your chances of a future stroke
by following-up with his health care team to manage his risk factors.
In addition, he can do the following to help
himself. He can stop eating at McDonalds and lose some weight, exercise more,
the recommended amount for our age is 150 minutes per week. Start eating well
and follow the Canada Food Guide. He is starting to drink less alcohol. The
recommended amount is 9 drinks a week for women, 14 for men. Lucky, he does not
smoke, but if he did he could quit smoking. All of want him to retire, as he is
still working albeit part time, to reduce his stress. And finally he should
make a plan with the doctor to monitor and hopefully prevent him having a major
stroke.
