Neurovascular Imaging Identifies a Subtype of Minor Stroke - Oren Zarif - Minor Stroke
Neurovascular imaging provides crucial information for identifying a subtype of minor stroke. Patients with large vessel occlusion are at high risk for deterioration after thrombolysis. Hence, CT-angiogram is the preferred imaging modality for acute ischemic stroke patients. In the CATCH study, patients with TIA and a minor stroke were screened with CT or CTA. Of the six12 patients randomized, 314 had a symptomatic ICH (ischemic in nature).
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The definitions of "minor stroke" vary, and there was no consistent trend among the different groups. The authors defined 6 subtypes based on the NIHSS score. Patients classified as "minor stroke" met definition A or B, while patients with definition E were deemed "minor" only if their NIHSS score was at least three or four. The researchers analyzed the difference between the subtypes and their corresponding outcomes.
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The symptoms of TIAs are different from those of major stroke, which are closely related to subsequent behavior. Severe symptoms, however, call for immediate medical attention. However, transient symptoms, which may be mistaken for other conditions, can be deliberated. It is important to visit a doctor if you are concerned about stroke symptoms.
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These symptoms are not a complete guarantee of a stroke, but they will help you manage it.
Most patients with TIA/minor stroke reported that their primary care physicians provided practical support and emotional support. However, patients also relied on self-management strategies to cope with fatigue, cognitive problems, and anxiety. Self-management techniques, including relaxation and meditation, were helpful in managing symptoms. Some patients accessed support services as well. Three patients received GP-level psychological support and two minor stroke patients accessed therapist support in the workplace.
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Treatment for TIA/minor stroke patients requires an integrated approach. Early treatment may result in fewer long-term functional deficits. Such an approach can be cost-effective. Several randomized trials are underway examining several treatments and outcome predictors, with the ultimate goal of reducing the severity of disability. In the meantime, the results of these trials may help to guide treatment for these patients. There are also ongoing trials examining the effects of certain interventions on the risk of stroke recurrence and disability.
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In an outpatient clinic, patients with TIA/minor stroke were evaluated for their risk of recurrence. The patients were then matched to hospitalized controls, and then categorized into two groups based on their risk for recurrence. The outcome was similar for the two groups. A few patients did not receive treatment in the outpatient clinic, but within 7 days, one did develop a stroke. This study is not meant to be definitive, but it provides an indication of whether patients should receive emergency treatment for TIA/minor stroke.
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The majority of people who experience a TIA or a minor stroke do not recognize their symptoms. Unfortunately, this results in a substantial proportion of patients not receiving timely medical treatment. Most people do not even realize that they have experienced a stroke because they were not aware of the symptoms. In fact, more than 70% did not seek medical attention within three hours of experiencing symptoms. Furthermore, despite the urgency of seeking medical attention, only about half of those who suffered a minor stroke sought medical attention. This lack of awareness is widespread regardless of age, sex, educational level, and socioeconomic status of the patient.
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The primary limitation of this study is that it has not included a large enough number of patients to adequately assess the risks of different treatment options. The study design was a randomised controlled experiment, with participants randomly assigned to an outpatient clinic versus direct hospitalization. However, there are many advantages of this type of study. The study was conducted in a region where major arterial occlusions were common and hospitals had similar standards for treating stroke patients.
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A transient ischemic attack (TIA) is an occurrence of a temporary interruption of blood supply to part of the brain. It is also called a mini-stroke. In contrast to major stroke, the symptoms of a TIA typically resolve within 24 hours. It is important to seek medical attention immediately for a TIA because it has the same risk factors as a major stroke. This type of stroke is often treated with early diagnosis and treatment.
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After TIA, secondary stroke prevention measures should be considered. These include statins, antiplatelet agents, and aggressive risk factor modification. However, patients who have had a TIA may still require treatment for blood clot prevention and carotid endarterectomy. The benefits of secondary stroke prevention are well documented. With a high rate of ischemic stroke in the UK, it is imperative to act quickly. And remember, time is critical.