Many don’t seek prompt help after ‘mini-stroke’

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Three out of 10 people who suffer a minor stroke or a “mini-stroke” don’t get medical help in time, upping their likelihood of going on to have a major stroke, new research shows.

While the importance of rapid treatment for stroke is now widely recognized, less is known about whether people who suffer mini-strokes get prompt care.

People who have these mini-strokes—what doctors call transient ischemic attacks, or TIAs - are now known to be at high risk of full-fledged strokes in the following hours and days, Dr. Arvind Chandratheva of the University of Oxford in the UK and colleagues point out in the journal Stroke. What’s more, it’s fairly easy to identify who among these patients is at highest risk, and starting preventive treatments early is “highly effective.”

The symptoms of a TIA are the same as those of a stroke; the big difference is that they’re temporary. Symptoms can include weakness or an inability to move all or part of one side of the body; feelings of numbness or tingling on one side; visual disturbances; trouble speaking and understanding others; and dizziness and fainting.

Current guidelines state that people should see a doctor within 24 hours of having a TIA or minor stroke. To investigate whether this is happening, Chandratheva and his colleagues surveyed 1,000 consecutive TIA or stroke patients participating in a large study of heart attack, stroke, and other acute events possibly related to a blocked blood vessel.

Among the patients who had TIAs, 459 in all, 67 percent sought medical help within 24 hours, and 47 percent did so within three hours, the researchers found. Among the 541 patients who had minor strokes, 74 percent got medical help within a day, and 46 percent did so within three hours. Three-quarters of the study participants went to their primary care physician first.

There were 129 patients who had a recurrent stroke after their initial TIA or minor stroke; 30 percent had not sought treatment before having a second stroke.

Certain factors like incorrect recognition of symptoms were associated with delays in treatment among TIA patients, the researchers found, but a person’s socioeconomic status, age, or gender had no effect on whether they delayed seeking treatment.

More public education is needed, the researchers conclude, both to help people recognize symptoms of TIA and minor stroke and to understand the need for quick medical attention.

“Without more effective public education,” they conclude, “the full potential of acute prevention will not be realized.”

SOURCE: Stroke, June 2010.

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