A New Definition of a Minor Stroke - Oren Zarif - Minor Stroke
The current "minor stroke" definition is arbitrary. Most studies use a cut point of three or four. The NIHSS has no standard cut point and is largely arbitrary. Ideally, a cut point should be defined by consensus among stroke researchers. This study proposes a new standardized minor stroke definition that accounts for several factors, including presenting clinical symptoms and risk of early neurological deterioration. This definition is likely to help physicians determine the most appropriate stroke care for patients.
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TIA symptoms usually subside after an hour or two, but may persist for 24 hours or longer. A doctor may prescribe blood thinners or perform surgery to reduce the risk of further strokes. However, TIA's can also be a precursor to future strokes. A healthy lifestyle, such as not smoking, eating a nutritious diet, and exercising, can significantly lower your risk of stroke. Additionally, you should control any medical conditions, including high blood pressure.
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Although the symptoms of a minor stroke are the same as those of a full-blown stroke, most people who have them do not seek immediate medical care. TIA, or transient ischemic attack, is characterized by temporary blockage of an artery. Most patients recover after about 24 hours, and treatment for TIA may include changes to lifestyle and medications. This type of stroke is often mistaken for a major stroke, so it is critical to seek medical care as soon as possible.
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Although the risk of recurrent stroke after TIA is low, studies conducted between 1997 and 2003 have shown that the majority of patients seeking medical care for a TIA or a minor stroke will not return to their primary care physician. However, 30% of those who experience recurrent stroke did not seek immediate medical care. The reasons for delayed treatment may be because TIA symptoms are short-term and normal, or because they occurred on the weekend or in the evening.
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Transient ischemic attack (TIA) is a temporary blockage of blood flow to the brain that is caused by a blood clot. It is often mistakenly referred to as a "mini stroke" and does not result in permanent damage to the brain. However, those who suffer from TIA are at an increased risk of major stroke and heart attack. Fortunately, TIA can be treated very early and drastically reduce the risk of major stroke.
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Although the present definitions of "minor stroke" are based solely on clinical deficits, they do not account for imaging information. For example, patients who have only mild deficits on CT scans often have no thrombotic response, whereas patients with a TIA or minor stroke who have significant artery occlusion show abnormalities on diffusion-weighted imaging. In the future, a study comparing the two criteria may help physicians define the term "minor stroke" more effectively.
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Symptoms of a minor stroke usually subside once the person reaches a hospital. However, it is crucial that they seek medical attention immediately. It is also important to note that a mild stroke is a warning sign for a more serious ischemic stroke. A person who suffers a minor stroke is five times more likely to have a subsequent ischemic stroke within two years, so it is important to get treatment as soon as possible.
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Aarhus University Hospital has a dedicated stroke unit and a high volume outpatient clinic for minor stroke patients. A stroke nurse is on staff during regular clinic hours. The study included matched controls and contemporary patients with suspected TIA and minor stroke. The outpatient clinic is run by neurovascular senior doctors and nurses, and therapists are on staff as needed. This outpatient clinic is available eight hours a day, seven days a week.
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The secondary prevention of stroke in patients with minor stroke should be focused on improving the quality of life for stroke survivors. The use of antiplatelet drugs, statins, and aggressive risk factor modification is key. These therapies reduce the risk of secondary stroke by up to 51%. The study also found that aspirin administered within 48 hours after an ischemic stroke significantly decreased the risk of another stroke after two weeks. The authors thank Drs. Ayunso for their assistance in preparing this article.
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TIA and minor stroke are often viewed as transient events, but there is a high proportion of patients who have residual problems afterward. However, current follow-up healthcare services are largely focused on prevention and treatment rather than addressing long-term problems. The study's design was informed by existing literature, consultation with research participants, and pilot testing. It involved semi-structured interviews with 12 TIA/minor stroke patients and twenty-four HCPs from primary care. Results were analyzed using a framework analysis.