Mini-stroke: what it is, how to detect it early, and why it shouldn't be underestimated

Transient ischemic attacks (TIAs), also known as mini-strokes, involve a temporary blockage of blood flow to the brain. Two recent studies have revealed the aftereffects of these episodes, which can leave significant and lasting effects on patients.

The consequences of these blockages were determined through an analysis conducted by Aalborg University in Denmark. This trial looked at 354 participants with an average age of 70 and showed that more than 50% of those who experienced a "mini-stroke" reported prolonged fatigue that could last up to a year.

Therefore, one way to detect it is by noticing prolonged fatigue, which, according to research, can present in different forms: from general, physical tiredness to a reduction in activity, decreased motivation, and mental exhaustion. Furthermore, 61% of participants reported experiencing this symptom just two weeks after leaving the hospital, and 54% continued to experience it up to a year after the event.

The research team was led by Dr. Boris Modrau, who teaches at Aalborg University Hospital. Together, they determined that these TIA-related aftereffects could not be explained by the presence of persistent blood clots, as brain scans showed no significant differences between patients with and without fatigue.

Experts also found that before a mini-stroke, anxiety or depression was twice as common among those who reported prolonged fatigue.

Furthermore, emotional and psychological factors influence how patients experience ongoing fatigue, leading physicians to call for more comprehensive post- mini-stroke care that includes the assessment and management of these psychological conditions.

On the other hand, the study indicated that monitoring patients diagnosed with TIA was essential to identify which individuals might need specialized care, with the aim of counteracting the effects of this prolonged fatigue,

Another study was published in JAMA Neurology in February. The result? Indeed, TIAs can have a lasting impact on people's cognition.

These effects are comparable to a full-blown stroke, according to neuropsychologist Victor Del Bene of the University of Alabama at Birmingham and lead author of the study. This is despite the fact that the initial symptoms resolve quickly. Therefore, the finding underscores the importance of taking TIAs seriously, as they can disrupt people's cognitive ability over the long term.

The University of Alabama at Birmingham study, “Cognitive Decline After a First Transient Ischemic Attack,” analyzed data from more than 30,000 participants over the age of 45 with no history of stroke or TIA.

Another finding indicates that, first, patients do not experience a sudden cognitive change. However, five years later, deterioration in this area is evident, regardless of demographic factors, chronic illnesses, or normal aging.

Eric Smith, a neurologist at the University of Calgary, emphasized in an accompanying editorial to the study published in JAMA Neurology that TIAs are not as transient as previously thought. While they don't always lead to dementia, they alter a person's cognitive trajectory. Furthermore, other risk factors, such as heart disease, diabetes, or smoking, can increase the risk of cognitive decline and dementia over time.