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TIAs are emergencies, not just ‘mini-strokes,’ group says

Arm weakness and numbness are among the symptoms of a transient ischemic attack, or TIA. (Getty Images)

Transient ischemic attacks, or TIAs, should no longer be thought of as mere “mini-strokes,” but rather harbingers of a bigger stroke to come, according to the American Heart Association.

In new guidance, the group says that at least 240,000 Americans experience a TIA each year and calls on medical providers to treat TIAs as emergencies.

The statement gives medical providers guidelines on how to evaluate patients who suspect they’ve had a TIA. The condition occurs when a temporary blockage of blood to the brain produces strokelike symptoms that swiftly resolve.

Because symptoms tend to disappear within an hour, it can be hard to diagnose suspected TIAs, according to the guidance.

For years, TIAs were popularly nicknamed mini-strokes, but the term is a misnomer. In a news release, AHA officials say a TIA “is more accurately described as a warning stroke.” Though they are less severe than full-blown strokes, TIAs lead to full strokes in about 1 in 5 patients within three months. Nearly half of those full-blown strokes occur within just two days, the scientists write.

The guidelines call on medical providers to use both brain imaging and risk assessment scores to determine whether a stroke damaged the brain and point to patients at risk for a larger stroke. Providers should look into symptoms and medical history, then conduct a CT scan to rule out conditions that can mimic TIA.

Patients should get an MRI scan within 24 hours of the symptom onset, the report recommends.

Rural and underserved hospitals without on-site neurologists or with limited access to imaging should participate in telemedicine networks that connect providers to one another and transfer patients to hub hospitals for imaging or arrange for outpatient MRIs, the guidance states.

“Incorporating these steps for people with suspected TIA may help identify which patients would benefit from hospital admission, versus those who might be safely discharged from the emergency room with close follow-up,” said Hardik P. Amin, an associate professor of neurology who chaired the association’s scientific statement writing committee, in the news release. Amin is also the medical stroke director at Yale New Haven Hospital.

TIAs share the same symptoms as strokes: facial drooping, arm weakness, speech difficulty, dizziness. People with other cardiovascular risk factors such as obesity, high blood pressure and smoking are at higher risk.