After a mini-stroke, expect progressive cognitive decline, says study

New Delhi: Patients who experienced a transient ischaemic attack (TIA), commonly referred to as a "mini-stroke," showed significant cognitive deterioration over time, despite recovering quickly from the initial stroke symptoms, revealed a cohort study published in JAMA Neurology recently.

The study found that while TIA patients exhibited no immediate cognitive changes following the event, their annual rates of cognitive decline were comparable to those observed in stroke patients.

TIA occurs when blood flow to specific brain regions is temporarily interrupted, usually due to a clot. Symptoms typically subside within 2 to 15 minutes. This is in contrast to strokes, where neurological deficits persist beyond several hours, usually causing permanent damage.

Although brain imaging techniques like MRI scans can detect brain damage in stroke patients, TIA episodes often show little to no detectable changes in such imaging.

Healthcare experts stress that even in the absence of obvious stroke indicators, patients remain at risk. Warning signs of TIA include sudden unilateral weakness or numbness, speech difficulties or comprehension issues, visual disturbances, vertigo, coordination problems, and intense headaches. These symptoms arise suddenly when brain cells temporarily lack oxygen and nutrients. While short-lived, the underlying causes of TIA—such as atherosclerosis, blood clots, or heart issues—pose significant health risks.

Doctors in the city emphasise the importance of prompt medical attention following a TIA. Swift evaluation helps identify the root causes and implement preventive measures against future strokes.

Dr PN Renjen, senior consultant of neurology at Indraprastha Apollo Hospitals, explained that TIAs are often underestimated because the symptoms resolve quickly. However, they represent a medical emergency and a critical warning sign. "TIAs can significantly affect a person's quality of life, both in the short and long term. In the short term, they can cause fear, anxiety, and uncertainty about future health. The long-term effects, though more subtle, are equally concerning," he said.

Dr. Rajul Aggarwal, director of neurology at Sri Balaji Action Medical Institute, highlighted that cognitive deficits are common among TIA patients, affecting their ability to focus, process information, and perform daily tasks. These impairments can also negatively affect their social relationships and work performance, underscoring the need for cognitive support after TIA care.

The emotional and psychological impact is also significant. Many patients report symptoms of anxiety, depression, and heightened stress due to concerns about potential strokes.

"Almost 1 in 3 individuals who experience a TIA will eventually have a stroke, with about half occurring within a year. Therefore, the risk increases, and a TIA should be taken very seriously, as it indicates a high risk for a future stroke. The risk is highest in the days and weeks following a TIA, making immediate medical attention crucial," Dr Aggarwal added.

Dr. (Col) JD Mukherjee, vice chairman and head of neurology at Max Superspeciality Hospital, Saket, emphasised the importance of not delaying help. "If you suspect you've had a TIA, don't wait—call emergency services or head to the hospital immediately, even if you feel better," he advised.

Post-treatment healthcare is crucial: maintaining a nutritious diet low in sodium and fats, incorporating regular physical activity, and avoiding tobacco and alcohol consumption are essential. Patients should adhere to their medication schedule, especially anticoagulants, and monitor their blood pressure, blood sugar, and cholesterol levels as per their physician's recommendations. It is also important to remain vigilant for any recurrence of symptoms and attend all scheduled medical check-ups.