Ministrokes Deserve Maximum Attention

Do you know what a ministroke is? If you do, you're among the minority. A ministroke, or transient ischemic attack (TIA), is a brief episode of stroke symptoms caused by temporary interruption of blood flow to the brain. Most people suffer TIAs without realizing it.

But a third of the time, TIAs precede the full-blown, disabling strokes that are the nation's third leading cause of death. Each year, 750,000 Americans have such strokes -- and 160,000 die.

In a stroke, fatty deposits or blood clots block a blood vessel (ischemic stroke) or, less commonly, weakened vessels burst (hemorrhagic stroke). Blood flow to that part of the brain ceases and brain cells die rapidly. Sometimes damage goes unnoticed, but other strokes leave victims unable to talk or use limbs.

Treatments can limit damage -- but only if given within three hours of a stroke, says the National Stroke Association (NSA). If you have any of these symptoms, call 911 immediately:

• 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, or loss of balance

• Sudden severe headache

If you have any questions or concerns -- about your risk of a stroke, for instance -- talk with your physician.

What's the truth about strokes?

Myth: If symptoms are brief, fast action isn't needed.

Reality: TIA symptoms last only seconds because the clot quickly dissolves, but a TIA shows that stroke conditions exist. Full-blown strokes often follow within a day. While stroke symptoms can be subtle, an evaluation with a brain scan and aggressive treatment are crucial. For a hemorrhagic stroke, you'll need surgery to stop the bleeding. For a blocked artery, clot-busting drugs can restore blood flow in half an hour. On the horizon: a quick-acting catheter vacuum that sucks blood clots from the brain.

Myth: You can tell if your blood pressure is high.

Reality: High blood pressure has no symptoms, yet it makes your risk of stroke four to six times higher. Lowering the diastolic blood pressure (the lower number in a reading) by 5 or 6 points can cut your stroke risk more than 40 percent. You often can do that with a low-fat diet and brisk walking, but you also may need medication. Other risk reducers: stop smoking (it hardens the arteries and doubles your risk); control diabetes (it speeds plaque formation); keep cholesterol low (high cholesterol prompts plaque buildup); limit alcohol to about two drinks a day for men and one for women (more boosts blood pressure) and lose weight. Dropping 10 pounds decreases blood pressure, improves cholesterol levels and cuts the risk of diabetes.

Myth: Several aspirin daily offer the best defense against stroke.

Reality: Aspirin prevents clotting and often is prescribed to head off a second ischemic stroke, but more than 15 aspirins a week could raise your risk of a hemorrhagic stroke, experts say. Ask your doctor about aspirin, its side effects and an appropriate dosage.

Myth: Stroke targets everyone equally.

Reality: Compared with white Americans, African Americans are twice as likely to have strokes and die from strokes. This may be because African Americans have more risk factors such as hypertension and diabetes, says the NSA. In general, stroke risk is seven times higher for adults over 65, and women account for six out of 10 deaths. Black women have a 70 percent higher risk of stroke death than white women.

Myth: An irregular heartbeat has nothing to do with stroke.

Reality: Checking your pulse for extra or irregular heartbeats can find such problems as atrial fibrillation. (Place your fingers on your wrist pulse-point to check.) In this common abnormal heart condition, the heart's upper chambers don't empty completely. Blood pools, allowing clots to form. Those clots can travel to the brain, causing a stroke. Treatment includes blood-thinning medications.