Treatment of a mini stroke

The term “mini-stroke” refers to a Transient Ischemic Attack (TIA). A mini-stroke is a cerebrovascular accident which causes stroke symptoms, but the symptoms disappear within one to two hours.

­The transient incident does not cause permanent brain damage. When stroke symptoms occur, there is no way of knowing if the cause is a TIA or a full stroke. Call 911 or the local number for emergency medical services, even if the symptoms disappear within minutes. Because mini-strokes can be caused by hardening of the arteries,­ atherosclerosis, a TIA may also indicate an increased risk for heart attack. Rarely, a mini-stroke may be caused by bleeding in the brain. Initial diagnostic tests will determine the cause of the TIA.

Treatment of mini-stroke is intended to prevent a major stroke. Almost 20% of patients who experience a mini-stroke, if untreated, will have a major stroke within 90 days. Anti-coagulants or “blood-thinners” are given, often for long-term use. Aspirin is most often prescribed for patients who have had a mini-stroke. Aspirin affects the platelet cells in the blood, decreasing their ability to join together and form clots.

If a patient already on aspirin therapy has a TIA, then a combination drug of aspirin and dipyridamole called Aggrenox may be prescribed. Other drugs such as Clopidogrel, heparin, or Coumadin may also be used.

It is extremely important to take these medications exactly as prescribed. Report any side effects at once. Make certain that all doctors and pharmacists are aware of all medications taken. Anti-coagulants are powerful drugs, and may interact with other medications, even over-the-counter drugs.

If blockages in the carotid arteries are found, a surgical procedure called carotid endarterectomy may be recommended to remove the blockages and widen the arteries. Sometimes a device called a stent is implanted, to help keep the arteries open to allow adequate blood flow to the brain.

Most risk factors for stroke can be controlled by medications. The major risk factor is atrial fibrillation, a disorder of the heart’s rhythm. A patient with atrial fibrillation will be referred to a cardiologist for evaluation and treatment options.

Other risks include diabetes, high cholesterol, family history of stroke and high blood pressure. Obesity, tobacco use and excessive alcohol consumption are risk factors for atherosclerotic heart disease, which can lead to stroke. Prompt treatment of stroke can prevent disability and tragedy. A mini-stroke is a major warning. Do not ignore it!

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