Only one in 10 people who suffer a mini-stroke make their way to the emergency department for prompt treatment and fewer than half get treatment quickly enough, according to a troubling new study.
The research, published in today's edition of the medical journal Stroke, is of concern because those who suffer transient ischemic attacks (TIAs or mini-strokes) are at high risk of being felled by a full-blown stroke within hours or days.
"A TIA is an urgent problem that requires rapid assessment," said Michael Hill, a spokesman for the Heart and Stroke Foundation of Canada. "It's a warning sign and it should be acted upon immediately."
A TIA occurs when blood flow is temporarily blocked to an area of the brain, temporarily causing classic stroke symptoms. These can include sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or co-ordination; or sudden, severe headache with no known cause.
"If you have any one of these symptoms, you should head to the emergency room," Dr. Hill said.
According to the new study, however, only a small minority of TIA sufferers heed that potentially lifesaving advice.
Matthew Giles, a research fellow in clinical neurology at the University of Oxford in England and principal author of the study, said it demonstrates an alarming ignorance about TIAs.
The study of 241 people, average age 71, who had a documented TIA found that 44 per cent had delayed seeking care for days. An equal number, 44 per cent, sought care promptly, although most made their way to a family physician rather than an emergency room. The balance, 12 per cent, sought treatment the same day they had a TIA, but not in any urgent manner.
Dr. Hill, who is an associate professor in the stroke program of the Calgary Health Region, said TIAs are under-recognized, underestimated and undertreated.
He said that because doctors tend to see patients who have had TIAs with few serious consequences (because those who have full-blown strokes die or end up in trauma centres), "there was a general medical perception that it was okay to have a TIA."
But that belief has changed markedly in recent years as research has shown that one in five TIA sufferers will have a stroke within three months -- and that many of these "brain attacks" occur within 48 hours.
In Calgary, patients who have had a TIA are now admitted to hospital to undergo a battery of tests. By doing this, the number of strokes has been reduced by almost half.
"If you treat TIAs aggressively, you can prevent stroke," Dr. Hill said.
