Take a Mini-Stroke Seriously, Seek Medical Attention

Physicians call them transient ischemic attacks, but they are more commonly known as “mini-strokes.” But make no mistake – they can be deadly.

What is worse, many people who suffer such an attack rarely seek medical help.

Just one in 10 people who experienced symptoms of a transient ischemic attack (TIA) sought the proper emergency care, says a recent study published in the journal Stroke.

Urgent care is critical, because some people who suffer TIAs will have a major stroke as soon as a day or two after the mini-stroke.

“People need urgent medical attention not for the symptoms that have passed but for what might be coming,” says Dr. Keith Siller, medical director of the Comprehensive Stroke Care Center at New York University Medical Center.

“Many people don’t have a TIA before they have a stroke, so, in a sense, it’s fortunate to have one. Now you have a chance to intervene,” he says.

Symptoms Similar to Major Stroke

A transient ischemic attack occurs when blood flow to a part of the brain is temporarily blocked. When this occurs, symptoms come on suddenly and last anywhere from a few minutes to many hours.

Symptoms may include:

• sudden loss of speech or the ability to understand others
• rapid onset of weakness or numbness of the face, arm or leg, especially if it occurs on only one side of the body
• sudden loss of, or change in, vision that may occur in one or both eyes
• sudden difficulty walking or maintaining balance

One thing you may not feel with a stroke is pain.

“Pain is not the right thing to look for in stroke,” says Dr. Christian Schumacher, a neurologist at the Stern Stroke Center at Montefiore Medical Center in New York City. “People expect that like a heart attack, which is often painful, that stroke will cause pain. But stroke symptoms are, in most cases, without pain.”

One exception, adds Dr. Siller, is what is known as a hemorrhagic stroke. In this instance, you would likely experience a sudden, severe, unexplained headache. If you have such a headache or any of the above symptoms, says Dr. Siller, you should get to the hospital immediately.

Unfortunately, not many people realize the need for urgent care. In the Stroke study, British researchers surveyed 241 people who had experienced a transient ischemic attack.

Just 44.4 percent sought medical care within a few hours of experiencing TIA symptoms, and only 10 percent sought any emergency medical care at all for their symptoms.
Another 44 percent waited longer than a day after their symptoms to seek care.

Persons with symptoms that lasted more than one hour, as well as those with motor symptoms such as difficulty walking, were more likely to seek care.

If the TIA symptoms occurred on a weekend, people were more likely to delay seeking treatment.

People “want to wait until they feel better, and most TIAs get better within an hour. If it gets better, people just think, ‘Oh, that was weird,’ and then they may call their doctor later,” says Dr. Schumacher.

Or, they may just forget the symptoms altogether, says Dr. Siller. “When symptoms are gone, and they feel better, people forget. But, it’s a misconception that if it went away, it doesn’t mean anything.”

Physicians Determine Severity

Dr. Schumacher notes, “Although TIA is called a mini-stroke; it’s like having a real stroke. It’s a warning sign for a major disabling stroke.”

Getting to the hospital as soon as possible after TIA or stroke symptoms begin is critical. The reason: Clot-busting drugs that can spare you many of stroke’s worst effects – including paralysis – have to be administered within several hours after the onset of symptoms to be effective, explains Dr. Siller.

“If you wait, we can’t do as much to help you,” he says.

Dr. Siller also recommends discussing your risk factors with your physician.

The most common risk factor for stroke is a past history of a stroke or a TIA. People with high blood pressure, high cholesterol, diabetes, and those with heart disease also have an increased risk of stroke, making it even more important for them to act quickly if they have any TIA symptoms.

Always consult your physician for more information.

Winter Months Bring Elevated Blood Pressure, Experts Say

It turns out blood pressure has a chill factor: Hypertension is harder to control in colder weather, according to experts at a recent meeting of the American Heart Association.
This concept has been around a while says a heart expert.

“It has been noted for decades that people’s blood pressure tends to be a little bit harder to control or a little bit higher in cold climates,” says Dr. Kenneth Baker, at the Texas A&M Health Science Center in Temple, Texas.

Cold = Vasoconstriction = Hypertension

The study was led by Dr. Ross Fletcher of Georgetown University. The researchers drew on a vast database: the Veterans Administration’s storehouse of 1.8 billion vital statistics records.

The five-year study looked at electronic health records for almost 1.2 million patients cared for at 15 VA hospitals located at different latitudes: Anchorage; Baltimore; Boston; Chicago; Fargo, ND; Honolulu; Houston; West Los Angeles; Miami; Minneapolis; New York City; Philadelphia; San Juan, Puerto Rico; Portland, Oregon; and Washington, DC.

The average age of participants was 66. Fifty-one percent were Caucasian, 21 percent were Hispanic, and 27 percent were African American. Less than 4 percent were female.
Within the sample, almost 444,000 veterans had high blood pressure (based on readings of more than 140/90 on three separate days).

And, regardless of their locale, patients experienced an average difference of almost 8 percent in getting their high blood pressure back to normal between winter and summer, with that feat being much tougher in winter.

Outside expert Dr. Baker speculated about any number of reasons.
“My guess is that one of the top reasons is, when you’re in a cold atmosphere, you vasoconstrict [blood vessels narrow],” he says.

“If you stick your hand in ice water, it has the same effect,” notes Dr. Baker. “Blood pressure goes up a little, and in hotter climates, sitting by the pool in your swimming suit, the vessels in the skin are dilating, you lose water and sweat off salt, and blood pressure drops.”
There are other possible factors as well. Cold medicines people take in the winter can raise blood pressure, as can non-steroidal anti-inflammatory painkillers.

Winter Brings Alcohol, Coffee, and Food

Persons also tend to be more depressed in the darker months, leading to more alcohol and coffee consumption, both of which can raise blood pressure, says Dr. Baker.

A more obvious reason: Persons are also often more sedentary in the winter, staying inside and eating more. This can have a secondary effect – weight gain – which also contributes to hypertension.

Dr. Baker believes that these biological or lifestyle differences are more likely to explain the findings than southern or northern climate or the amount of light.

Overall, however, VA hospitals in all the cities studied showed improvements of about 4 percent per year in their ability to keep patients’ average blood pressure under control, the study found.
Always consult your physician for more information.