Mini-Stroke Found to Precede 1 in 8 Strokes

Expert urges reliance on other predictive tools, but not all agree

By Ed Edelson
HealthDay Reporter

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TUESDAY, Sept. 29 (HealthDay News) -- Just one of every eight strokes is preceded by a milder interruption of blood flow to the brain, called a transient ischemic attack (TIA), a new Canadian study shows.

And because of that, the researchers conclude, such an attack is not the crucial warning sign that physicians need.

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"The clinical implication of this study is that we cannot rely on the TIA as a warning signal to tell us to intervene to prevent a stroke because it is seen before only one of every eight strokes," said Dr. Daniel G. Hackam, an assistant professor of medicine in neurology at the University of Western Ontario in Canada and lead author of a report in the Sept. 29 issue of Neurology.

"We need better risk profiles to predict a patient who will have that first stroke," Hackam said. "This study is highlighting a gap in our knowledge base. If we know a stroke is impending, we can intervene to prevent that stroke."

In the study, Hackam and his colleagues found that, of the 16,409 people diagnosed with stroke over a four-year period in Ontario hospitals, 2,032 -- or 12.4 percent of them -- had a TIA in the weeks before the stroke.

A TIA, he said, does not have enough predictive power to warrant intensive preventive measures.

"We need better tools," Hackam said. "That is really the main message of our paper."

A TIA, which some refer to as a mini-stroke, occurs when a clot briefly blocks a brain artery. Symptoms of a TIA are the same as those of a stroke -- sudden onset of weakness or numbness in an arm or leg, loss of vision or double vision, speech difficulty, dizziness, loss of balance -- but they go away, often in a few minutes. Many people ignore the symptoms, but they are clear signs of possible trouble, Hackam said.

The numbers in the new study are similar to those about TIA and subsequent stroke that have been reported for decades, said Dr. Larry B. Goldstein, director of the Duke Stroke Center. But he disagrees with Hackam's interpretation of the predictive importance of TIAs.

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