Stroke alerts, what are they? Seek emergency care even if the signs go away soon | Health | Magazine

A transient ischemic attack (TIA) or ‘stroke alert’ It is a sign of high risk. It’s important to seek immediate medical attention, says the American Heart Association (AHA). Even if the symptoms disappear in a matter of an hour, this event can herald a stroke in the future (three months or less).

A new scientific statement from the AHA describes how to evaluate patients experiencing a TIA, with special guidance for physicians working in rural areas, where there are no imaging studies or resident neurologists.

Nearly one in five people suspected of having a TIA will have a stroke within three months.and two in five, with the proper examination, will know that they have actually suffered a complete stroke, rather than just a TIA.

Stroke symptoms, even if they pass soon, require emergency medical attention. Photo: Shutterstock

Comprehensive evaluation of patients with suspected TIA with imaging and use of the risk assessment scale it can help determine which patients should be hospitalized because they are at higher risk of a full-blown stroke.

The symptoms of a TIA do not cause permanent damage, but they do serve as a warning. They are the same as stroke, only sudden, severe, and temporary (less than an hour. They may be some or all of the following:

  • Facial paralysis.
  • Weakness on one side of the body.
  • Numbness on one side of the body.
  • Trouble finding the right words/difficulty speaking.
  • dizzinessloss of vision or difficulty walking.

The acronym FAST can be used to recognize them

F = face (face): droopy or numb face

A = arms (arms): weakness in one arm

S = speech: speech difficulty

T = time (time): time to call 911, even if the symptoms go away.

Diagnosing a TIA is difficult, as most patients have normal function by the time they arrive in the emergency room, explains Hardik P. Amin, M.D., chair of the Scientific Statement Writing Committee, associate professor of neurology, and chief medical officer for Seizures Brain at Yale New Haven Hospital, St. Raphael Campus, in New Haven, Connecticut.

Dizziness and difficulty walking are two of the symptoms that prevent a possible stroke. Photo: Shutterstock

Also, in an emergency room with limited resources there will not be the same evaluation as in a certified stroke center.

With emergency room physicians or internists in mind—professionals in resource-limited areas—the statement recommends learning to differentiate between TIA and a similar condition that is due to other causes, such as hypoglycemia, seizures, or migraine. What is the difference? That in the latter case, the symptoms spread to other parts of the body and their intensity increases over time.

Who is at risk for a transient ischemic attack?

  • People with cardiovascular risk factors, such as high blood pressure, diabetes, obesity, high cholesterol, and smoking-
  • People with peripheral arterial disease, atrial fibrillation, sleep apnea, and coronary artery disease.
  • People who have had a previous stroke.

What tests should be done first in the ER?

After evaluating the symptoms and medical history, imaging of the blood vessels in the head and neck is important.

  • Tomography head CT scan without contrast to rule out intracerebral hemorrhage and TIA mimics.
  • Angiography by CT scan to look for signs of narrowing in the arteries leading to the brain.
  • Picture of magnetic resonance (MRI), to rule out brain injury (i.e., stroke), within 24 hours of symptom onset.

About 40% of patients who present to the emergency room with TIA symptoms will be diagnosed with a stroke based on the MRI results.

You must complete the blood test to rule out conditions that can cause symptoms similar to those of TIA, such as hypoglycemia or an infection, and to detect cardiovascular risk factors such as diabetes and high cholesterol.

Once a TIA is diagnosed, a cardiac workup is recommended. This could be a follow-up visit with the appropriate specialist, within a week of having a TIA.

It is suggested a electrocardiogram to assess heart rhythm and detect atrial fibrillation, which occurs in up to 7% of people with a stroke.

The American Heart Association recommends that the long term cardiac monitoring within six months after a TIA is reasonable if the initial evaluation suggests a heart rhythm problem as the cause of the TIA.

Early neurological consultation, either in person or by telemedicine, is associated with lower mortality rates after a TIA, either during the ER stay or within 48 hours, given the high risk of stroke in the next 48 hours. later days.

About 43% of people who have had an ischemic stroke (caused by a blood clot) had a TIA within the week before the stroke. (YO)

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