People who have "warning strokes," known as transient ischemic attacks (TIAs), before suffering a stroke have better outcomes than those who suffer full-blown strokes with no prior warning, Daniel G. Hackam, M.D., Ph.D., of the University of Western Ontario, has found.

One out of every eight strokes is preceded by a "warning stroke," according to his research, published in the September 29 print issue of Neurology.

"When people experience TIAs--also known as mini-strokes--they might feel weakness or numbness, usually on one side of the body; trouble with speech or comprehension; trouble with vision, or other symptoms," Dr. Hackam tells DOTmed News.

For the study, Dr. Hackam identified all people at Ontario hospitals with a diagnosis of stroke during four years. Of the 16,400 patients, 2,032, or 12.4 percent, had a TIA prior to the stroke. During a TIA, stroke symptoms last for less than 24 hours and then are resolved.

Those with no warning were more likely to die while at the hospital (15.2 percent compared to 12.7 percent); more likely to have a heart attack while in the hospital (4.8 percent compared to 3.1 percent) and less likely to be ready to go home after the hospital stay, rather than to a nursing home (40.1 percent compared to 43.1 percent), Dr. Hackam found.

He also discovered that those patients who had "warning strokes" were typically older than those who didn't. They were also more likely to have diabetes, high blood pressure and heart problems.

"It's possible that the blood vessels of those with warning strokes were preconditioned to the lack of blood flow, which protected them from the larger stroke," Dr. Hackam speculates.

He adds, "Any person who experiences minor stroke symptoms should get to the emergency room immediately."

Stroke Prevention

Dr. Hackam says physicians need to better manage risks so that strokes can be prevented entirely. Previous studies have shown that up to 80 percent of strokes after TIAs can be prevented when risk factors are managed intensively, he notes.

About 60 percent of all strokes are due to high blood pressure. Other risk factors include diabetes, smoking, advanced age, high cholesterol, and family history of stroke, Dr. Hackam says. Certainly, he tells DOTmed, diabetes, smoking, and cholesterol levels need to be assiduously managed to prevent stroke.

Source: American Academy of Neurology

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