‘Mini’ Strokes Can Have Mega Health Effects


Carolyn Howard-Johnson was at base camp on Mount Everest, researching local monasteries on the internet when it happened—the life-long writer and author of several books could no longer read.

"I suddenly noticed that I wasn't understanding what I was seeing on the screen," she says.

The feeling soon passed and Howard-Johnson, author of the "HowToDoItFrugally" book series and instructor at the UCLA Extension Writers' Program, went to bed that evening without mentioning the episode to anyone else in the camp.

The next morning at breakfast, an off-hand comment to their guide, Peter Hillary (famous for summiting the highest peak on all seven continents), and a telephone consult with the expedition doctor, put Howard-Johnson on an emergency plane flight to a hospital in Beijing.

Hours later, the doctors told Howard-Johnson that she had suffered a transient ischemic attack (TIA), often referred to as a "mini stroke."

Mini stroke: A long-term health threat

According to the American Heart Association, more than one in every two Americans over the age of 60 will have at least one mini stroke—which occurs when blood flow to the brain is temporarily obstructed.

When compared with a full-blown blockage, a mini stroke seems like a minor incidence. But, mini stroke effects can have lasting consequences on a person's physical and mental health.

"Research suggests that one or more mini strokes can progressively interfere with cognition and other brain functions that support balance, strength and gait," says William Likosky, M.D. a board certified neurologist and medical director of the Swedish Neuroscience Institute's Stroke Program.

Fifteen percent of people who experience a mini stroke develop some type of lasting disability within three months, according to Canadian researchers who examined the brain scans of 500 TIA survivors.

A mini stroke can also herald an impending full-strength stroke.

"It is believed that TIAs are warning signs of a stroke," according Ivan Mikolaenko, M.D., F.A.A.N., a board certified neurointensivist who says that as many as 15 percent of people who have TIAs die within a year of their first episode.

Sneaky symptoms mask mini stroke effects

Most mini strokes happen with little fanfare, which makes them all the more dangerous.

"It wasn't that severe. And it went away fast," says Howard-Johnson, whose primary symptoms—slight dizziness and a temporary disruption in her reading comprehension—came and went within minutes.

Sometimes the symptoms linger a little longer.

Joe Parsons, founder of PFS Funding, a residential mortgage brokerage company, was doing his daily crossword one Tuesday when he noticed his writing becoming slightly sloppy. Brushing it off, he went to work, where a newly-acquired limp nagged him as he walked to his office.

It took 48 hours for Parsons' gradually weakening leg and persistently unsteady hands to bother him enough that he decided to contact his insurance company's on-call advice nurse—she told him that he was likely suffering from a stroke and that he needed to find someone to drive him to the emergency room immediately.

The importance of early treatment

If left untreated, a mini stroke may resolve on its own.

But, a person experiencing the classic stroke symptoms of, blurry vision, numbness in the face or extremities, weakness and slurred speech, should always seek medical treatment as soon as possible to avoid permanent brain damage.

Parsons' doctor said that he was lucky he came in when he did. If he had waited much longer, the blockage could have caused irreversible harm.

Research has shown that people who receive treatment for a mini stroke (typically a combination of drugs meant lower cholesterol, blood pressure and prevent clotting) within 24 hours of the onset of their symptoms could decrease their risk for having a major stroke in the near future by up to 80 percent.

A life-altering episode

While a person's risk for having a stroke of any sort increases with age, even younger, healthy people need to take mini strokes seriously.

Howard-Johnson had just passed a rigorous physical in order to be cleared to go on her expedition to Everest, but her experience taught her to take her health more seriously.

Both she and Parsons have upped their exercise regimens and are far more likely to forgo the excuses and get to the hospital if they feel something is wrong.

"Almost every day, I see an older lady who is out with her walker," says Parsons. "She keeps up a pace equivalent to a very brisk walk. When I feel like being lazy and skipping my run, I think of her."

Going beyond the purely physical, Howard-Johnson says her mini stroke also taught her the value of making the most of each and every day she has.

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My son is 42 now. He has PTSD and a lot of other mental health problems. Every day is different and nothing surprises me anymore.
I believe he had a mini stroke yesterday. He could not understand anything I said and he could not speak. His right arm and hand were affected. Normally, I would rush him to the ER, but get this: 9 months ago I found him unresponsive for quite a while, then he couldn't talk or understand, he was unsteady and couldn't focus. This is serious stuff, so I called 911. When he got to the ER at Kaiser, there was no rushing around, though I stressed that he had Stroke symptoms. By the time the doctor came in, he could speak a little....he was better, but on physical exam, he had no strength in his left arm. The doctor ordered a CT. Result - he must have had a non headache migraine or seizure. He was also too young and didn't have the risk factors....? Bad doctor, I say. Many young people, even babies have strokes. He does have both of those on a regular basis, but his was different. No one seemed to listen or care. His neurologist was called and the ER doctor was told he has occasional seizures. He has had many seizures (pseudo and convulsive!). I found out that strokes don't show up on CTs for a few days, so I called his neurologist and had to talk him into doing another CT or MRI. He was condescending and said he would order an MRI to satisfy me. Then I get the condescending email (no phone call) that said "As I thought, Justin's MRI was negative for stroke." Maybe he did have a "migraine" or something that mimicked a stroke, but still, he was not given the attention, given his symptoms. We are getting out of Kaiser soon. WE are in charge of our bodies and should stick up for ourselves or our loved ones. Even though I wasn't proven right for a stroke, something is happening to my son. Sometimes he's fine and brilliant and a little manic, but a lot of the time he doesn't remember what happened that day or the day before. No one takes his physical symptoms seriously and his mental symptoms are not being treated like they should be. I'm hoping by changing health systems, we find some doctors and therapists who really care. Thanks for reading this and hope it helps someone.
If the mini-stroke is not treated, can a person develop worsening numbness in arm and leg months after the stroke?
Very Informative