From the Guidelines
A minor stroke, also known as a transient ischemic attack (TIA), is defined as a brief episode of neurological dysfunction caused by focal brain or retinal ischemia, with clinical symptoms typically lasting less than an hour. According to the national stroke association guidelines for the management of transient ischemic attacks 1, this definition has been proposed to replace the classical definition of a TIA, which was defined as a rapidly developed clinical sign of focal or global disturbance of cerebral function lasting fewer than 24 hours. The symptoms of a minor stroke include sudden weakness or numbness on one side of the body, slurred speech, vision changes, dizziness, or severe headache.
Some key characteristics of minor strokes include:
- Temporary interruption of blood flow to part of the brain
- Stroke-like symptoms lasting less than 24 hours, typically resolving within minutes to hours
- No permanent brain damage, but a serious warning sign of potential future strokes
- Requires urgent attention due to the high risk of a major stroke within three months, with the highest risk in the first 48 hours
Diagnosis and treatment of minor strokes typically involve:
- Physical examination
- Medical history review
- Brain imaging tests like CT scans or MRIs
- Antiplatelet medications such as aspirin or clopidogrel
- Risk factor management including blood pressure control, cholesterol management, diabetes treatment if applicable, smoking cessation, and lifestyle modifications.
From the Research
Definition of Minor Stroke
A minor stroke, also known as a transient ischemic attack (TIA), is a temporary period of symptoms similar to those of a stroke, but it doesn't cause permanent damage. It is defined as a sudden neurologic dysfunction caused by focal brain ischemia with no imaging evidence of acute infarction 2.
Characteristics of Minor Stroke
Minor strokes are characterized by:
- Sudden onset of neurologic deficits
- No evidence of acute infarction on imaging
- Symptoms typically last less than 24 hours
- Approximately 10% of patients with TIA will have a stroke within 90 days without urgent evaluation and management 3
Diagnosis and Management
Diagnosis and management of minor stroke involve:
- Urgent evaluation and management to reduce the risk of stroke after TIA by up to 80% 3
- Use of validated measures such as the ABCD(2) and ABCD(3)-I scores to predict which patients are at greatest risk 3
- Dual antiplatelet therapy with aspirin and clopidogrel within 24 hours of presentation for patients with nondisabling acute ischemic stroke or high-risk TIA 2
- Lifestyle changes, such as regular exercise and weight loss, to reduce the risk of recurrence 3
Treatment Options
Treatment options for minor stroke include:
- Dual antiplatelet therapy with aspirin and clopidogrel, which reduces the risk of recurrent stroke by 26% compared to aspirin monotherapy 4
- Aspirin plus clopidogrel for 3 weeks followed by single antiplatelet therapy, which reduces stroke risk from 7.8% to 5.2% 2
- Carotid revascularization and single antiplatelet therapy for patients with symptomatic carotid stenosis 2
- Anticoagulation for patients with atrial fibrillation 2