What Is a Pre-Stroke?
A pre-stroke is another name for a transient ischemic attack (TIA, and also called a mini stroke), which is a temporary loss of blood flow or low oxygen to an area of the brain that can cause stroke symptoms. Unlike a stroke, a pre-stroke does not damage brain cells or cause permanent damage.
Pre-strokes are warning bells, because having a pre-stroke puts people at high risk for a future stroke.
What Are Symptoms of a Pre-Stroke?
There are generally no differences between the early signs of a stroke and pre-stroke (transient ischemic attack or TIA). The difference is whether the symptoms resolve or not, but while a TIA is occurring, it is nearly impossible to know the difference.
Both a pre-stroke and a stroke are medical emergencies. Call 911 and get to a hospital’s emergency department immediately if you have any symptoms of pre-stroke/stroke. Do not drive yourself.
The American Heart Association and the American Stroke Association suggest you know the signs of a stroke and act FAST.
- Face drooping: Does one side of the face droop or is it numb? Ask the person to smile.
- Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? Weakness or numbness usually appear on one side of the body.
- Speech difficulty: Is speech slurred, is the person unable to speak, or are they difficult to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?
- Time to call 911: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to a hospital immediately.
Other symptoms of pre-stroke and stroke include:
- Vision problems (partial vision loss in one eye, double vision, blurred vision, decreased vision)
- Hand, face, or leg weakness or numbness
Symptoms of a pre-stroke usually last a few minutes to a few hours. Pre-stroke may occur just once, or may recur several times per day, or once a year.
What Causes a Pre-Stroke?
Factors that can increase a person's risk of having a pre-stroke include:
- High blood pressure (hypertension)
- Age older than 40 years
- Current or past history of blood clots
- Heart disease (e.g., atrial fibrillation, carotid stenosis)
- High cholesterol
- Illegal drug use
- Heavy alcohol use
- Recent childbirth
- Previous history of pre-stroke/transient ischemic attack (TIA)
- Sedentary lifestyle/lack of exercise
How Is a Pre-Stroke Diagnosed?
Pre-stroke (transient ischemic attack) is a medical emergency. When a pre-stroke is occurring, it is nearly impossible to tell if it is a full stroke. Call 911 and get to a hospital’s emergency department right away if you have any symptoms of pre-stroke/stroke. Do not drive yourself or have someone else drive. If you are having a pre-stroke/stroke, emergency medical services (EMS) can begin evaluating and treating you immediately and they are equipped to handle medical emergencies.
A pre-stroke is diagnosed with the following:
What Is the Treatment for a Pre-Stroke?
The goal of treatment for pre-stroke (transient ischemic attack) is to reduce the risk of having a stroke in the future.
Treatments for pre-stroke include:
- Treating risk factors
- Antiplatelet therapy
- Anticoagulant therapy
- Revascularization: carotid endarterectomy
- A procedure that restores blood flow
What Are Complications of a Pre-Stroke?
Complications of a pre-stroke (transient ischemic attack) are a significantly increased risk of having a stroke. The risk is especially high during the first 48 hours following a pre-stroke.
One in three patients who have a pre-stroke will experience a future stroke. Any patient with a TIA will need close medical follow up even if all symptoms resolve.