Mini-Strokes Need Not Lead to Full Attack
Prompt treatment seems to be key to reducing risk

(HealthDay News) -- Quick treatment of a so-called mini-stroke greatly reduces the likelihood of a later full-blown stroke, researchers have found.

A mini-stroke, or transient ischemic attack (TIA), causes symptoms similar to a stroke but, unlike a stroke, the symptoms tend to disappear within a few hours.

Researchers at the University of Oxford in Britain found that rapid treatment of TIA reduces the risk of a subsequent major stroke by 80 percent.

Their study included 591 people who'd had a TIA. One group had been assessed and treated within a day of the attack. In the others, assessment came within a day, but treatment didn't occur, on average, for about 20 days.

About 2 percent of those treated quickly, compared with 10 percent of those for whom treatment was delayed, had a full-blown stroke within 90 days. Risk reduction was independent of age and sex, and early treatment did not increase patients' risk of bleeding or other complications.

"Our data indicate that urgent assessment and early intervention of a combination of existing preventative treatments can reduce the risk of recurrent stroke after TIA or minor stroke by about 80 percent," the study authors wrote in The Lancet . They said that could mean the prevention of almost 10,000 strokes a year in the United Kingdom alone.

"Follow-up treatment is required to determine long-term outcome, but these results have immediate implications for the service provision and public education about TIA and minor stroke," the researchers concluded.

A commentary on the study, also published in The Lancet , stressed that people who've had a TIA or minor stroke are not disabled and added that, if "the risk of a disabling stroke can be substantially reduced in this population, we strongly recommend that patients should receive the same urgent attention as is provided for those with acute coronary syndrome."

In a related study, French researchers examined outcomes at a 24-hour hospital clinic for people with suspected cerebral or retinal TIAs.

Assessment took place within four hours of admission. Of the nearly 1,100 patients treated at the clinic, the 90-day stroke rate was 1.24 percent. That's about 80 percent lower than the almost 6 percent stroke rate predicted by scores calculated on the basis of age, blood pressure, clinical features, diabetes and durations of symptoms, according to the study, published in The Lancet Neurology .

The researchers said their results "show that prompt evaluation and treatment of patients with TIA in a dedicated outpatient unit is associated with a lower than expected risk of subsequent stroke." With nearly three-fourths of TIA patients discharged the same day as they're diagnosed, "the TIA clinic is also likely to involve lower costs and greater patient satisfaction about their management than is treatment without such a clinic."

On the Web

To learn more about TIA, visit the American Heart Association.

SOURCES: HealthDay News ; Oct. 9, 2007, online issue, The Lancet ; Oct. 9, 2007, online issue, The Lancet Neurology
Author: Robert Preidt
Publication date: Oct. 31, 2008
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