'Mini' Strokes Can Lead to Major Disability, Study Finds


The findings, in fact, were so alarming that the study authors suggested that doctors should consider administering the clot-busting medicine known as tissue plasminogen activator, or tPA, for patients who show up at the hospital after a TIA or minor stroke.

"If patients have symptoms that are mild, we are even currently doing a study to use thrombolysis, in those cases," she said.

Currently, tPA is only indicated for use in patients experiencing full-blown stroke. But as for whether the benefits of this medicine outweigh its risks in patients experiencing mini strokes, most doctors say more research is needed.

"There is no evidence at all that treating TIA acutely with tPA would make any difference," said Dr. Jeffrey M. Katz, director of the stroke center and stroke unit at North Shore University Hospital in Long Island, N.Y. "I think that many times we decide not to treat patients with minor symptoms from stroke because of the risk for bleeding with tPA and the thought that these patients will do well anyway."

But, Katz adds, "this is probably one of the largest studies to say that no these patients may not do well... Of course it says nothing about whether they would do well with tPA, but I think it certainly suggests that they aren't doing better if left untreated."

Noles, for one, did not have tPA treatment, but he did have the clot in his brain removed shortly after his TIA. Currently, he said, he has no symptoms and no disabilities despite the episode years ago. He takes medications to control his blood pressure, cholesterol level and he exercises.

"If I had ignored my symptoms down the road, then maybe weeks or maybe months later, I would have had a major stroke or died," Noles said.

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