The #1 Mini-Stroke Symptom Most People Miss, According to a Cleveland Clinic Neurologist
Woman experiencing mini stroke symptoms
Every year, nearly 800,000 people will have a stroke, according to the CDC. Most of these strokes will be what's called "ischemic," which happens when blood flow to the brain is blocked.
People who have these strokes may have already experienced what's known as a Transient Ischemic Attack (TIA) or mini-stroke.
"Mini-strokes, also known as transient ischemic attacks, are brief episodes, which are a result of lack of blood supply to a specific part of the brain," says Dr. Ahmed Itrat, MD of Cleveland Clinic's Neurological Institute.
Dr. Itrat says people who experience mini-strokes are at a higher risk of having a major stroke within the following year. CDC data reports that about 10 to 15% of people will have a major stroke event within three months of a TIA. When treating strokes, time is of the essence and life-saving.
"Acting quickly when one is experiencing symptoms of stroke by calling emergency services and reaching the hospital in time can lead to a major impact on increased survival and reduced disability," Dr. Itrat says.
The symptoms of a mini and major stroke aren't much different, but Dr. Itrat says ones from a TIA will resolve in a short timeframe. In either case, calling for help is critical. However, Dr. Itrat says it's easy to brush off the signs of a mini-stroke, especially one.
The Number One Sign of a Mini-Stroke People Miss
The top sign you're having a mini-stroke is often sudden-onset dizziness or trouble walking. "[These signs] may be a hallmark of an evolving stroke," Dr. Itrat says.
He says these signs usually involve a subjective feeling that you or the area around you is spinning. "This may also be accompanied by nausea, vomiting and difficulty [walking]," Dr. Itrat adds.
It sounds miserable, so why might people ignore it? "Dizziness is a common symptom that can have many causes other than stroke," Dr. Itrat says. "People often attribute dizziness to a vertigo spell related to inner ear dysfunction and do not act right away. Sudden-onset dizziness, especially in someone with risk factors for stroke, should be taken seriously and evaluated right away."
There's a reason you feel dizzy when having a mini or major stroke, and it has to do with what's going on in your body. "Acute dizziness or imbalance, called 'ataxia,' in a stroke or TIA occurs due to loss of blood flow to the base of the brain, which contains structures vital to the balance and coordination of the body," Dr. Itrat explains.
This coordination includes connections from the inner ear and a part of the brown known as the cerebellum that controls the balance needed to walk and stand.
"If untreated, this can result in injury to parts of the nearby brain critical for vital functions of the body, such as breathing and maintenance of consciousness," Dr. Itrat says. To be clear, dizziness isn't a surefire sign of a mini-stroke. According to 2018 research published in Stroke, dizziness is the reason for 4.4 million emergency room visits annually, and stroke is the reason for 3% to 5% of these cases. Still, getting help as soon as possible is essential to determine the reason for the sudden spinning sensation.
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Other Signs of a Mini-Stroke to Look For
Dr. Itrat says that sudden dizziness is one sign of a mini-stroke, but it's not the only one to note.
Sudden onset one-sided weakness
Speech difficulty
Double vision or loss of vision in one eye
Again, these symptoms are also red flags of a major stroke. They can also be signs of other disorders or issues, like migraines. However, Dr. Itrat says there's a key characteristic that providers will hone in on if they suspect it is a stroke.
"Symptoms of TIA or stroke usually impact one side of the body, which distinguish it from other disorders such as migraines or neuropathy, where individuals may have more generalized symptoms such as tingling on both sides of the body," Dr. Itrat explains.
What To Do If You Think You're Having a Mini-Stroke
Get help. Just because symptoms often resolve quickly doesn't mean a mini-stroke isn't serious. "Since there is no guarantee that the symptoms will completely resolve, it is best to seek immediate medical care by calling EMS to be taken to the nearest emergency department," Dr. Itrat says. "If symptoms are all resolved and there is access to an urgent TIA clinic, then a detailed evaluation there can also be helpful."
Doctors can also discuss other risk factors for a major stroke event and help you determine the next steps to protect your health long-term.
Can You Recover After a Mini-Stroke?
By definition, yes. "A mini-stroke or TIA refers to an episode which is self-limiting/self-resolving, and therefore, individuals should not be expected to have a disability as a result," Dr. Itrat says.
The time it'll take for episodes to resolve varies.
"These episodes last from a few minutes to a few hours," Dr. Itrat shares. "Somebody experiencing symptoms of stroke for longer than 24 hours should not be considered as having a mini-stroke/TIA."
What Are the Risk Factors for a Mini-Strokes?
Risk factors for mini-strokes don't differ from those for major ones. Some are modifiable, and Dr. Itrat says they include:
Elevated blood pressure
Tobacco use
Obesity
Elevated cholesterol
Abnormal heart rhythm, such as atrial fibrillation
Obstructive sleep apnea
Alcohol consumption
Diabetes mellitus
"Presence of pre-existing heart disease, clotting disorder and a family history of cardiovascular disorders also predispose to stroke risk," Dr. Itrat says. "We are seeing an alarming trend in rising rates of strokes in younger individuals, and early screening for preventable risk factors is key."
Discuss concerns and risk factors with your primary care physician, who can take bloodwork and refer you to specialists as needed.
Next up: The #1 Sign of Cognitive Mild Cognitive Impairment You Should Never, Ever Ignore
Sources
Stroke Facts. CDC.
Dr. Ahmed Itrat, MD of Cleveland Clinic's Neurological Institute
About stroke. CDC.
Diagnosing Stroke in Acute Dizziness and Vertigo. Stroke.
