Health Matters: A mini stroke may be a warning sign


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By Paul Kaiser, M.D.

Did you know that according to the American Stroke Association, people who have severe strokes often report having earlier warning signs?

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In fact, among patients who are treated for a blockage-related stroke (called an ischemic stroke) up to 40 percent report experiencing a mini-stroke or transient ischemic attack (TIA) first, according to the American Stroke Association.

That’s why it is important to recognize the symptoms of a mini-stroke and seek prompt medical attention even if the symptoms last only a few minutes.

At Penn Medicine Princeton Medical Center, designated by the State of New Jersey as a Primary Stroke Center, specially trained acute stroke teams are available 24/7 to diagnose stroke.

As a Primary Stroke Center, PMC maintains neurology and Emergency Department personnel trained in the diagnosis and treatment of acute stroke, as well as acute rehabilitation services for patients.

A Temporary Blockage

A transient ischemic attack is a temporary blockage of blood flow to the brain caused by a clot that disappears on its own or gets dislodged so that it stops causing symptoms.

Because the blockage is brief, blood flow is restored quickly, leaving no lasting damage to the brain.

However, a TIA is a warning sign that can indicate the likelihood of a full-blown stroke in the future. As the American Stroke Association reports, about a third of the people who experience a TIA go on to have a severe stroke within a year.

A TIA is often the result of a buildup of cholesterol-containing fatty deposits called plaques (atherosclerosis) in an artery or one of its branches that supplies oxygen and nutrients to the brain. These plaques can decrease the amount of blood flowing through the artery or cause a clot to develop.

While anyone can experience a TIA, certain factors can increase your risk, including:

  • Family history of TIA and stroke
  • Being over the age of 55
  • Prior mini-strokes
  • Smoking
  • Obesity
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Heart or blood vessel disorder

Watch for These Symptoms

Symptoms of a mini-stroke are the same as a full-blown stroke and may include sudden onset of:

  • Weakness, numbness or paralysis of the face, arm or leg, usually on one side
  • Slurred or garbled speech
  • Difficulty comprehending language
  • Double visions or loss of vision in one or both eyes
  • Dizziness or loss of concentration
  • Severe headache

Though these symptoms may resolve quickly, proper medical evaluation is needed to determine whether you have had a TIA, a stroke or another medical problem and whether treatment is needed.  If you experience symptoms of a TIA or stroke, call 9-1-1 and seek immediate medical care.

Diagnosis and Treatment

In diagnosing a TIA or stroke, doctors will take a complete medical history and perform a physical and neurological exam.

Diagnostic imaging tests such as an MRI may be ordered to determine the location and extent of brain injury, if any.

Treatment for a TIA generally focuses on prevention. Certain medications may be prescribed to help reduce the tendency of blood to clot. In some situations, surgery may be recommended to clear arteries from fatty deposits before another TIA or a stroke can occur.

In the case of a full-blown stroke, one of the most important treatments is a drugcalled t-PA (tissue plasminogen activator). However, t-PA can only be injected within three hours of the onset of symptoms. The drug can prevent lingering disabilities in patients with a certain type of stroke.

Because immediate care is critical to a stroke patient’s survival and recovery, PMC is committed to having a stroke team, including specially trained physicians and registered nurses, available within 15 minutes following the diagnosis of a potential acute stroke.

To help prevent TIA and stroke, the American Stroke Association recommends:

  • Preventing or controlling high blood pressure. High blood pressure is the number one risk factor for stroke.
  • Eating a healthy diet. Foods like fruits, vegetables, fish and whole grains can lower your risk for stroke.
  • Quitting smoking. Smoking is another leading risk factor for stroke.
  • Being physically active. Set a goal of getting 150 minutes of exercise a week.
  • Controlling blood sugar. Left untreated, diabetes can cause a number of health complications that can lead to stroke.
  • Losing weight.A healthy weight can help regulate blood pressure and control blood sugar.
  • Managing cholesterol. High cholesterol can lead to atherosclerosis.

Remember, a TIA is often a warning sign. Heed the symptoms and seek medical attention to avoid a full-blown stroke and stay healthy.

For more information about the PMC Stroke Center or to find a physician affiliated with Princeton Health, call 888.742.7496 or visit

Paul Kaiser, M.D., is board certified in clinical neurophysiology, neurology and vascular neurology. He is a member of the Penn Medicine Princeton Health medical staff.

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