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Fluids & Electrolytes
Dramatic results from two major studies suggest that promptly treating transient ischemic attacks (TIAs), sometimes called ministrokes, cuts the risk of a full-blown stroke within 3 months by as much as 80%. Strokes and TIAs cause the same signs and symptoms, such as sudden numbness or weakness of the face, arm, or leg (typically on one side) or sudden difficulty speaking. But TIAs appear to resolve spontaneously, usually within 24 hours.
In a British study of 591 patients who'd had TIAs, one group received standard care: treatment at an outpatient clinic within 3 days and medication therapy as indicated (such as antiplatelet, antihypertensive, and anticoagulant therapy) initiated after a typical wait of 20 days. The other group received treatment and medications within 24 hours. The results were striking: Those receiving standard care had a 10.3% chance of a major stroke within 90 days; this risk dropped to 2.1% for those treated immediately. As reported in The Lancet, the results held true regardless of the patients' age and sex. Early treatment didn't increase the risk of intracerebral hemorrhage or other bleeding.
These findings were echoed by a similar study published in The Lancet Neurology. Following 1,085 patients who'd had suspected TIAs, French researchers found the risk of a more serious stroke within 90 days was 1.24% among those treated within 24 hours, compared with the predicted rate of about 5.96% based on historical data.
British and French researchers agree: Even "minor" strokes are medical emergencies and should be treated aggressively to prevent a crippling or fatal stroke.
Rothwell PM, et al., Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): A prospective population-based sequential comparison, The Lancet, October 20, 2007; Lavallee PC, et al., A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): Feasibility and effects, The Lancet Neurology, November 2007.
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