Neurology Insights

The “Mini Stroke”: A Not-So Mini Warning Sign

Man in sun having effects of a possible mini stroke.

Did you know?

Every 40 seconds, someone experiences a stroke, the leading cause of long-term disability in the United States.

Yet, however unpredictable and life-changing strokes are, there is an early (and often underestimated) warning sign that can potentially alter the course of one’s outcome. This warning sign is a Transient Ischemic Attack (TIA), also known as a “mini stroke.”

Detecting early warning signs can save your life

When it comes to stroke, the consequences can be severe and life-altering. Much of this is due to their sudden and unpredictable nature and life-altering conditions ranging from loss of motor skills, speech and language dysfunction, memory issues, etc.

As a neurologist, I believe an ounce of prevention is absolutely worth a pound of cure. With strokes, identifying any early warning signs can mean the difference between permanent damage, repeated stroke attacks, and more.

What is a “Mini Stroke,” formally known as a Transient Ischemic Attack (TIA)?

A Transient Ischemic Attack is a temporary blockage of blood flow to the brain that mimics the symptoms of a full stroke. As its name suggests, these symptoms are often transient and short-lived, meaning they go unnoticed or dismissed because they typically only last anywhere from seconds to a few minutes. Mini stroke symptoms differ from a typical stroke, where blood flow blockage is blocked entirely.

However tempting as it may be to brush aside or second-guess symptoms of a mini stroke, we now know this event is now regarded as an early warning sign for a future stroke or multiple strokes.

According to the latest data and research, nearly 35% of individuals who experience a “mini stroke” will experience a full-blown stroke within the next few days.  

This early warning sign is so crucial that the American Heart Association suggests TIA’s no longer be regarded as a “mini stroke” but “more accurately described as a warning stroke.” In their recent scientific statement, they urge all individuals who suspect an attack of seeking an emergency assessment within the hour.

The silver lining of TIA is that if caught early and treated immediately, it typically does not result in permanent brain damage. Future strokes are likely to be prevented depending on the efficacy of the treatment.

Symptoms of Mini Stroke (Transient Ischemic Attack)

The symptoms of a mini stroke are often subtle and short-lived, which is why they are so easily ignored, dismissed, and underestimated. If you have a loved one experiencing any of the following symptoms, don’t wait until it’s too late, and make sure they seek medical attention immediately!

  • Extreme dizziness
  • Loss of balance and coordination
  • Sudden numbness or muscle weakness on one side of the body
  • Severe migraine (with no known cause)
  • Difficulty speaking or carrying on a conversation
  • Sudden changes in vision, including blurriness in one or both eyes
  • Sudden onset of confusion

Who is at risk for Mini Stroke?

There is a common misconception that strokes typically only affect older adults; however, data has shown that while strokes do more frequently occur in specific populations, all age groups, genders, and ethnicities can experience a stroke.

The most common and highest risk for Transient Ischemic Attack has been identified in the following groups:

  • Individuals with high blood pressure (hypertension)
  • Individuals living with peripheral artery disease, or coronary artery disease
  • Diabetic patients
  • Individuals who are obese
  • Individuals with high cholesterol
  • Chronic smokers
  • Individuals who have obstructive sleep apnea
  • Previous stroke patients

Diagnosis & Treatments for Mini Stroke

With a mini stroke, diagnosis and treatment are time-sensitive. The sooner one seeks medical attention, the quicker one can receive medical attention and potentially prevent life-altering complications from unfolding.

Short-term and long-term treatment options for mini stroke include:

Brain imaging

With an MRI or a CT scan (typically done within 24 hours of the attack), your neurologist will be able to view neurological activity, identify any previous strokes in the brain and take a closer look into the possible origin of the transient ischemic attack. Scans can also rule out or evaluate possible complications, such as hemorrhage (bleeding in the brain) and more.

Vascular Studies

Obtaining a vascular study of the carotid and vertebral arteries is essential to make sure there is no major blockage or plaque formation that can lead to future strokes.

Cardiac Testing

Obtaining an ultrasound study of the heart, called an echocardiogram, can rule out disease of the heart valves, as well as any holes in the heart that may lead to small strokes. Also, heart rhythm testing can identify irregular heartbeats that may be a factor in precipitating strokelike events.


While every case is unique, effective treatment options for mini-stroke and the prevention of further strokes involve medication and therapies such as thrombolytic therapy, which can assist in dissolving blood clots and help prevent the formation of additional clots. They are often initiating aspirin therapy. If there are no contraindications, it can be a very simple and extremely effective way to reduce the risk of future stroke-like events.

Lifestyle changes

A change in diet and activity may be immediately implemented and monitored for individuals who smoke, live a sedentary lifestyle, or have previous health conditions.


Safe yet more invasive procedures, such as surgery, may be performed based on individual patient needs. Surgery may be necessary to remove fatty deposit buildup (plaques) or blood clots from the arteries leading up to the brain. The most common surgeries are carotid endarterectomy and thrombectomy. Other surgeries may involve implanting a stint (in a neck artery, for example) to open up a narrow blood vessel, relieving a previous blood flow restriction to the brain. If there are any abnormal structures of the heart, surgical intervention may be helpful to reduce cardiac risk as a source for stroke events.

Long-term Heart Monitoring

Suppose a Transient Ischemic Attack is determined to be due to a heart rhythm-related condition. In that case, the American Heart Association recommends long-term heart monitoring within six months for any individual who has experienced a mini stroke.  

What to do if you or someone you know is experiencing a mini stroke

With any stroke, it is crucial to act fast, follow the FAST protocol for stroke survival, and seek medical attention immediately!

Face: Is one side of the face numb or drooping?

Arms: Does one side have difficulty moving upwards when lifting both hands?

Speech: Is speech slurred?

Time: If any of the symptoms above correlate, act fast and call 911 right away!

At Neurology Office, we believe spreading awareness makes our communities healthier and stronger! Please feel free to share this resource with a friend, family member, or anyone who can benefit from this knowledge.

A message from Dr. Kandel

“A stroke is one of the most devastating neurologic conditions we see in the clinical practice of Neurology. Identifying potential causes and addressing medical conditions and lifestyle changes to reduce risk factors is essential in avoiding this life-altering condition. Simple measures that are important in other health conditions are important in stroke prevention: addressing blood pressure, reducing obesity, improving hydration, lowering cholesterol, controlling diabetes, and improving lifestyle and behavior choices (diet, nutrition, exercise) are all essential in reducing the risk of stroke events.”

Dr. Joseph Kandel portrait

Joseph Kandel, MD

Board Certified Neurologist
Serving Naples and Fort Myers, FL

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