Why ‘warning strokes’ require emergency attention

Any neurological deficit resembling a stroke requires emergency medical assessment, even if symptoms subside within an hour, according to a report from the American Heart Association.

The report offers guidance on identifying and evaluating a suspected transient ischemic attack, or TIA, which is often called a “warning stroke.” TIAs occur when blood supply to part of the brain is temporarily interrupted.

Symptoms are similar to a stroke but typically dissipate quickly, causing some people to write them off as insignificant. But failing to intervene could lead to a full-blown stroke and more permanent damage, says Dr. Demetrius Lopes, co-director of the Comprehensive Stroke Program at Advocate Health Care.

“Don’t minimize any neurological deficit, whether it lasts hours, minutes or even seconds,” Dr. Lopes says. “It’s important to recognize the signs and seek emergency medical attention. When it comes to stroke care, time is brain.”

At least 240,000 people in the U.S. experience a TIA each year, though the number is likely higher due to undiagnosed cases, the report says. Up to 18% of people who have a TIA will have a larger stroke within 90 days, with almost half of those strokes occurring within two days.

Identification can be tricky since symptoms are usually gone by the time the you seek medical attention. But accurately diagnosing a TIA and ruling out other conditions are crucial to providing the appropriate care moving forward, according to the American Heart Association.

“A comprehensive evaluation involving imaging and other tests can help determine cardiac or neurological factors that may have caused the TIA and increase future stroke risk,” Dr. Lopes says. “That’s why it’s critical for patients experiencing TIA symptoms to seek care immediately at a specialized clinic or emergency department. The sooner they are assessed, the quicker we can intervene and provide treatment to prevent a stroke from occurring.”

The report advises those who have experienced a TIA to undergo a full cardiac workup, including an electrocardiogram to assess heart rhythms and screen for atrial fibrillation. You should also be seen by a neurologist within the week – preferably within 48 hours, according to the guidance. Roughly 43% of people who have blood clot-related strokes experienced a TIA the week before.

An estimated one in four people over the age of 25 will have a stroke in their lifetime, according to the World Stroke Organization. Call 911 immediately if you witness or experience any of the B.E. F.A.S.T. warning signs:

Balance: Is the person experiencing loss of coordination?
Eyes: Is the person having trouble seeing?
Face: Ask the person to smile. Does one side of their face droop?
Arms: Ask them to raise their arms. Does one drift downward?
Speech: Is their speech slurred or strange?
Terrible headache and Time to call 911: Does the person have a terrible pain that feels like “the worst headache ever?”

Want to learn more about your risk for stroke? Take a free online quiz here.