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Mini-stroke can be major problem
Published November 11, 2006
The medical condition believed to have prompted the hospitalization of Albertville Mayor Carl Pruett is a complex condition, a local neurologist said.
Dr. Michael Watts, of Marshall Neurology in Albertville, discussed transient ischemic attack this week.
Doctors believe Pruett had a “mini-stroke,” which could have been a TIA. Watts said the complex condition is different than a stroke and stressed in an interview with The Reporter that he could only discuss the condition but not the mayor specifically.
A transient ischemic attack, sometimes referred to as TIA or “mini-stroke,” is a complex condition that is different from a stroke, according to Watts.
He said an attack is a “reversible event of lack of oxygen to brain tissue” that can be of multiple types and have multiple causes.
“A TIA can be caused from a blood clot in the heart or a blood vessel, such as the aorta, that breaks loose from the wall and goes downstream to the brain,” he said. “It can be from a blood vessel that breaks loose and travels to a smaller vessel and blocks blood flow and oxygen.”
Other causes include a sudden change in blood pressure, causing vasospasm and decreasing the oxygen to brain tissue, and anemia (low blood count) or polycythemia, meaning the blood is too thick, and fatty deposits (plaques) that build up in an artery and decrease the blood flow.
The effects usually last only a few minutes, Watts said. An event lasting longer than 24 hours is usually classified by doctors as a stroke.
A TIA can affect different parts of vision. Symptoms can include blindness, darkening or blurring of the eye or a bright flash through the vision (amaurosis fugax) on one side.
Watts said some patients present with aphasia, which is the inability to speak or inability to say the words intended. Dizziness, ataxia (wobbly gait) or balance disturbances may occur, and there can be loss of vision to one side (hemianopia).
Other symptoms, which may or may not be TIA-related, are dizziness alone, lightheadedness, vertigo, fleeting double vision, transient amnesia and visual disturbances or blurriness in both eyes.
“People with TIAs are more likely to have a stroke than the general population,” Watts said. “More than one-third of patients who have had a TIA will have a stroke at some time.”
He also said a history of TIA does not necessarily mean more attacks or a stroke will occur. The frequency of TIA is very high, much higher than that of strokes. They are also more likely to occur than strokes. The risk factors are the same for both conditions and include smoking, high blood pressure, high cholesterol, diabetes, sleep apnea and heart disease.
Pruett had a TIA in 2005.
The severity depends on what causes the TIA, Watts said, but there is more than one ideology on that issue.
He said most people are back to themselves completely within five minutes to one hour following an attack, but he encourages those with these symptoms to seek immediate medical care by calling 911 or a doctor or going to the emergency room at the hospital.
“Two episodes or more within 24 hours indicates a very high risk of something happening,” he said. “The best thing to do is to be evaluated effectively and quickly. The first few hours are very important.”
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