How serious are mini strokes?

What Is a Ministroke?

Brigid Dwyer, MD, is a board-certified neurologist and an Assistant Professor of Neurology at Boston University School of Medicine.

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A ministroke, also known as a transient ischemic attack (TIA), is a brief interruption of blood flow to the brain that improves on its own. TIAs produce temporary stroke-like symptoms, such as weakness on one side of the body or slurred speech, that lasts anywhere from a few minutes up to 24 hours with no lasting damage.

TIAs are «warning strokes» that are strong predictors of a stroke. Up to one-third of people who have a TIA go on to have a more severe stroke within one year. Prompt treatment for a ministroke can reduce your risk of having a stroke.

This article explores the causes and symptoms of ministrokes and how they’re treated.

What Is the Difference Between a TIA and a Stroke?

There are several differences between a stroke and a TIA. But, the main difference is that the symptoms of ministroke, or TIA, disappear completely within 24 hours, while strokes leave long-lasting physical impairments.

A ministroke occurs when there is a temporary period during which there is a lack of blood flow to an area of the brain. This is similar to a stroke, with the difference being that a ministroke improves because blood flow is quickly restored before permanent brain injury can occur.

In a stroke, however, blood flow remains impaired for long enough period of time to produce permanent brain injury.

Lack of blood flow is called ischemia. The medical term for a ministroke is a transient ischemic (TIA) attack because it is a brief period of ischemia that produces sudden neurological symptoms, or those affecting the nervous system.

Because ischemia impairs the function of brain cells, a person who is experiencing a TIA develops temporary problems in brain function, such as difficulty speaking or moving the face, arm, or leg on one side of their body.

Is a Ministroke the Same As a Silent Stroke?

No, they are not the same. A silent stroke is when someone has a stroke without realizing it. Usually, evidence of a silent stroke is found while undergoing a magnetic resonance imaging (MRI) test for another condition. They often do not even remember having any symptoms and are surprised when they get the news. A ministroke, on the other hand, is a brief but memorable event.

Causes of Ministroke

A healthy brain requires a constant delivery of oxygen and nutrient-rich blood to each one of its approximately 100 billion neurons, or brain cells. To ensure normal brain function, blood travels through multiple blood vessels to every part of the brain.

Sometimes, however, blood vessels become temporarily blocked by blood clots or cholesterol plaques, leaving areas of the brain briefly lacking enough blood supply. The resulting lack of oxygen and nutrients in these areas is known as ischemia.

A TIA resolves before permanent damage can happen. However, if the blood flow is not quickly restored, then a stroke occurs because neurons in ischemic areas become deprived of oxygen and nutrients and rapidly stop functioning.

Ministroke Symptoms

Ministroke symptoms begin suddenly and can range from mild to severe. They may involve physical impairment and loss of cognitive functions.

• Weakness of the face, arm, and/or leg on one side of body
• Numbness of face, arm, and/or leg one side of the body
• Inability to understand spoken language
• Inability to speak
• Unexplained dizziness or vertigo
• Loss of vision through one eye or both eyes
• Double vision or blurry vision

Most of the time, ministrokes are brief—lasting for only a few minutes. Others may last a few hours, but, by definition, they resolve within 24 hours.

Exactly what someone experiences depends on the part of the brain that is affected. For example:

• A person who suffers a ministroke in the area of the brain that controls hand movement may develop difficulty writing.
• A person who experiences a ministroke of a similar size in the brainstem—an area of the brain which harbors the centers for gait balance, voice control, and eye movements—might feel temporarily unable to carry on with their day because of vertigo (a sensation of motion and dizziness), difficulty speaking, or double vision.

Ministrokes are most noticeable when they affect the parts of the brain that control movement, feeling in the face, arm, or leg, or speech.

Treatment of Ministrokes

While ministrokes themselves improve, a ministroke is a sign that you are at risk of having a stroke. That is why, even if you have recovered, it is essential to seek medical attention right away if you experience stroke-like symptoms.

Seeking medical care immediately after a ministroke can reduce your short-term risk of stroke by as much as 90% and also lower your long-term risk of a stroke for at least a decade.

Sometimes, a person can experience a stroke within 24 hours of a first ministroke, and sometimes months or even years after a first ministroke. The problem is that you cannot predict if and when you will have a stroke if you have experienced a ministroke.

Your treatment plan will depend on the results of your TIA workup. After listening to your medical history and thoroughly examining you, your healthcare provider may run some tests to determine whether you have risk factors for stroke, such as:

• High blood pressure
• Heart disease
• Blood disease
• High cholesterol

Imaging, such as MRI or CT scan, may be used to get a view of blood flow and tissue of the brain, and an electrocardiogram (ECG) may be used look at your heart.

Your medical treatment will be tailored to lowering your chances of having a stroke based on your risk factors, and may include treatment with blood thinners.

Summary

A transient ischemic attack (TIA), or ministroke, is a temporary interruption of blood flow to the brain that resolves on its own and does not cause any permanent damage to the brain.

Ministroke symptoms vary based on the part of the brain affected but may include a dizzy feeling, loss of vision, numbness or weakness on one side of the body, or difficulty speaking or moving. Symptoms may last minutes or hours but will resolve within 24 hours.

A Word From Verywell

A ministroke requires medical attention. If you have had a ministroke, you have a strong chance of avoiding a stroke if you get started on preventative treatment right away.

Taking action to prevent a stroke after having a TIA can have a huge impact in terms of preventing disability, and even in prolonging your life. Consider a ministroke a health warning that you can gain control of.

7 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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2. National Institute of Neurological Disorders and Stroke. Brain basics: preventing stroke.
3. National Institute of Neurological Disorders and Stroke. Stroke: Hope Through Research.
4. Nadarajan V, Perry RJ, Johnson J, Werring DJ. Transient ischaemic attacks: mimics and chameleons. Pract Neurol. 2014;14(1):23–31. doi:10.1136/practneurol-2013-000782
5. American Stroke Association. What is a TIA?
6. Luengo-Fernandez R, Li L, Silver L, Gutnikov S, Beddows NC, Rothwell PM. Long-term impact of urgent secondary prevention after transient ischemic attack and minor stroke: ten-year follow-up of the express study. Stroke. 2022;53(2):488-496. doi:/10.1161/STROKEAHA.121.034279
7. American Heart Association. TIA treatment.

By Jose Vega MD, PhD
Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.

‘Mini Strokes’ Can Have Mega Health Effects

Carolyn Howard-Johnson was at the base camp of Mount Everest researching local monasteries on the internet when it happened. The lifelong writer and author of several books could no longer read.

“I suddenly noticed that I wasn’t understanding what I was seeing on the computer screen,” she recalls.

The feeling soon passed and Howard-Johnson went to bed that evening without mentioning the episode to anyone else in the camp. The next morning at breakfast, after making an off-hand comment to their guide and consulting the expedition doctor via telephone, Howard-Johnson found herself on an emergency flight to a hospital in Beijing.

Hours later, the doctors told her that she had suffered a transient ischemic attack (TIA), which is often referred to as a “mini stroke.”

What Is a Mini Stroke?

A mini stroke occurs when the flow of oxygen-rich blood to the brain is temporarily obstructed or reduced—usually by a blood clot or the narrowing of arteries due to atherosclerosis. TIAs typically last only a few seconds or minutes and do not cause permanent damage. When compared with a regular ischemic stroke, which can cause lasting brain damage, disability and even death, a TIA may seem like a minor incident. Mini strokes are much more insidious, but they can still negatively impact a person’s physical and mental health.

“Research suggests that one or more mini strokes can progressively interfere with cognition and other brain functions that support balance, strength and gait,” explains Dr. William Likosky, a board-certified neurologist and medical director for stroke at UCSF Fresno.

Furthermore, mini strokes can also alert patients and doctors to an impending major stroke. According to Dr. Ivan Mikolaenko, FAAN, a board-certified neurointensivist and chair of the neurology/neurosurgery disease management steering committee at South Nassau Communities Hospital in New York, “Ten to 15 percent of people will have a major stroke within three months of experiencing a TIA.”

Mini Stroke Symptoms

Most TIAs happen quickly and receive little attention, which makes them particularly dangerous.

“It wasn’t that severe and it went away fast,” says Howard-Johnson of her TIA symptoms in the Himalayas. Her primary complaints included slight dizziness and a temporary disruption in her reading comprehension. The experience was certainly odd, but she didn’t think much of it. Howard-Johnson’s subtle signs came and went within minutes, but in some people the symptoms linger a little longer.

Joe Parsons, a mortgage advisor, was doing his daily crossword one morning at his home in California when he first noticed his writing was a bit sloppier than usual. Brushing it off, he went to work and tried to ignore a slight weakness in his leg that produced an uncharacteristic limp when he walked.

Parsons’ leg gradually weakened further and his hand became increasingly unsteady. After 48 hours, he finally decided to contact the on-call nurse hotline provided by his health insurance company. The nurse explained that he was likely suffering from a stroke and needed to find someone to drive him to the emergency room immediately.

Anyone experiencing classic stroke symptoms like blurry vision, disorientation, sudden headache, slurred speech, and numbness and weakness in the face or extremities should always seek medical treatment as soon as possible. Another telltale sign of a stroke is when any of these symptoms occur on only one side of the body.

What Happens if a Mini Stroke Goes Untreated?

A mini stroke may resolve on its own, but it’s difficult to know just how serious the circumstances are without a thorough medical workup.

Familiarizing yourself with these symptoms will allow you to act quickly, which is crucial for avoiding permanent brain damage. Parsons’ doctor said that he was lucky he sought medical attention when he did. If he had waited much longer, the blockage in his brain could have worsened, causing irreversible harm.

Research has shown that people who receive treatment for a mini stroke within 24 hours of the onset of symptoms could decrease their risk for having a major stroke in the near future by up to 80 percent. Fortunately, the treatment for TIAs is relatively simple. After testing and risk assessment, patients typically receive a combination of drugs to lower cholesterol, control blood pressure and/or prevent clotting.

This treatment is important for remedying current symptoms and preventing additional TIAs and strokes. Even if a major stroke is avoided, repeated mini strokes can have a cumulative negative effect on one’s brain health and cognitive function. In severe cases, vascular dementia may result from untreated cerebrovascular events. According to the Alzheimer’s Association, screening for vascular dementia is recommended for all high risk individuals, including those who have had a stroke or a TIA and those who have risk factors for heart or blood vessel disease.

A Stroke of any Magnitude Can Be Life-Altering

While a person’s risk for having a stroke of any sort increases with age, even younger, healthy people need to take mini strokes seriously. Smokers, diabetics, those with high cholesterol, high blood pressure, and a personal and/or family history of stroke or heart disease are at the highest risk.

It’s hard to consider a TIA a blessing, frightening as it is, but a mini stroke can provide a critical wake-up call that immediate medical attention and lifestyle changes are necessary. This minor warning of an impending cerebrovascular incident also presents an invaluable opportunity.

Interestingly, Howard-Johnson passed a rigorous physical examination to receive clearance for her expedition to Mount Everest. Nevertheless, the experience taught her to take her health more seriously. Both she and Parsons have improved their diets and exercise regimens. Now that they know what a TIA looks and feels like, both also claim they are far more likely to seek emergency medical care if they feel something is wrong.