Why a mini stroke can be a major warning sign

May 26, 2023

This article was reviewed by our Baystate Health team to ensure medical accuracy.

Ennis J. Duffis, MD View Profile

‘Mini stroke’ is a common expression for what is officially called a transient ischemic attack (TIA) which occurs when the blood supply to part of the brain is temporarily interrupted. While the term ‘mini stroke’ sounds harmless, Dr. E. Jesus Duffis, a Neurointerventionalist at Baystate Health notes, “The reality is that a mini stroke, or TIA, is a serious condition and often serves as a warning that another—potentially more serious—stroke is likely to occur.”

How mini strokes differ from strokes

Mini strokes and strokes are both caused by a clot that interrupts blood flow to part of the brain. In most cases, stroke-inducing clots are located in the heart or carotid arteries. “The major difference is that with mini strokes, the blockage is temporary,” says Dr. Duffis, “As a result, the symptoms are also temporary. In most cases, they disappear with an hour but may last up to 24 hours. Even though the symptoms go away, you should never ignore the event. About one-third of people who have a mini stroke have an acute stroke at some time in the future—often within days of the mini stroke and even as far out as a year later.”

Recognizing a mini stroke

Some of the more common symptoms of a mini stroke are:

Vision changes in one or both eyes
Weakness in your arms or legs, usually on just one side
Difficulty speaking
Confusion
Loss of balance
Dizziness

“As with a full-blown stroke,” says Dr. Duffis, “the symptoms come on suddenly. At the earliest moments, it’s difficult to tell whether you’re having a TIA or a stroke. You should always assume you’re having a stroke and call 9-1-1. Even if it turns out you experienced a mini stroke and the symptoms go away, you still need to be evaluated for the cause and have it addressed so that you can avoid a several and potentially debilitating stroke.”

Treating a TIA

Describing a TIA as a “threatened stroke,” Dr. Duffis notes that even though the symptoms may pass, “The factors that led to a TIA occurring are still present—and threatening—in your body. This is why getting evaluated as soon after a TIA occurs is critical.”

Post-TIA evaluations may include a CAT-Scan, EKG, or MRI. “We’re basically looking to find the source of the mini stroke,” says Dr. Duffis. “In some cases, we may do imaging of the brain, arteries in the neck and the heart. Finding the cause of the issue is key to treating it properly.”

Like ischemic strokes, which are caused by blood clots as opposed to bleeding in the case of hemorrhagic strokes, TIAs can often successfully be treated with aspirin or similar medications. “If the issue is cardiac, blood thinners may be prescribed. In cases where a large clot is present, surgery may be the best option,” says Dr. Duffis.

Mini Strokes and Women

Stroke is the #4 cause of death in women, and women often have worse outcomes than men post-stroke due to a typically older age at the time of stroke onset. Much like with women and heart attacks, women can have different stroke symptoms than men. Women having a mini stroke or a stroke may experience fainting, weakness, confusion, hallucination, seizures, or other uncommon symptoms. Even if the symptoms resolve quickly, a mini stroke in women could cause damage and could lead to a more severe stroke in the future.

Women should be aware of the varied stroke symptoms they may experience, and call 911 for any of these symptoms or more standard stroke symptoms.

Stroke prevention and lifestyle intervention

Strokes are often described as sudden but, as Dr. Duffis notes, “There’s nothing sudden about what’s behind the cause of strokes.”

In his opinion, smoking and failing to see a doctor regularly are among the most important risk factors under one’s own control. “If you smoke, you’re twice as likely to die if you have a stroke. The longer you smoke, the greater the risk. That said, within hours of quitting smoking, your body starts to repair itself. The longer you stay smoke-free, the better your overall health and the lower your risk of stroke.”

Regarding seeing a doctor regularly, Dr. Duffis notes that a number of stroke risk factors, including high blood pressure and high cholesterol, are silent or invisible. “A regular check-up can reveal issues and allow you to take steps to reduce your risk.

“While you can’t control risk factors like age and gender, you can control whether or not you smoke and how well you maintain your health. Their important and powerful first steps to avoiding strokes of all types.”