A stroke happens in an instant, but its effects can last a lifetime. Over 150,000 strokes occur in the UK each year and more than 1.1m people are living with the devastating effects. Stroke is the third largest cause of death and the leading cause of adult disability in the UK. Although treatments for stroke can improve the outcome for patients, in the majority of cases, the benefits are limited. Prevention is, therefore, essential, and this is why I helped to set up the Stroke Prevention Research Unit at the University of Oxford.
While major strokes often occur without warning, in a significant proportion of cases, they are preceded by a 'warning' mini-stroke, or transient ischaemic attack (TIA). Each year, around 46,000 people in the UK have a mini-stroke, which is caused by a temporary disruption in the blood supply to part of the brain. The symptoms of a mini-stroke are similar to those of a major stroke - a sudden weakness down one side of the body, loss of speech, loss of vision, or some other neurological symptom - except that they are transient, usually lasting less than 24 hours.
The temporary nature of the symptoms of a mini-stroke should not, however, fool people into thinking that it is a benign condition - around one in 20 people will go on to have a major stroke within two days of having a mini-stroke. A mini-stroke must always be treated as a medical emergency - when the symptoms start, it's time to dial 999. We have shown that if patients are assessed and treated as an emergency in this crucial, early period, the risk of a major stroke is reduced by 80%.
Despite the considerable benefit of early treatment, research by the Stroke Association shows that by dismissing their symptoms as a 'funny turn', thousands of people who have a mini-stroke are missing the opportunity to prevent a major stroke from occurring. Over a third of people in the charity's report, Not just a funny turn, thought their mini-stroke was just a 'funny turn' and only one in five rang 999. We urgently need to challenge the misconception that a mini-stroke is nothing to worry about. Spotting the symptoms of mini-stroke, taking immediate action, and ensuring people are urgently assessed and treated, could prevent around 10,000 strokes each year and save over 3,000 lives.
Health professionals must also recognise the symptoms of a mini-stroke and act accordingly. Diagnosis can be difficult, as the symptoms reported by patients can sometimes be vague, and there are many other conditions, such as migraine and epilepsy, that can cause similar symptoms. However, recognition over the last decade of the very high risk of a major stroke after a mini-stroke, and of the enormous benefits of urgent treatment, has led to dedicated daily 'TIA clinics' in most hospitals in the UK and the rest of the developed world. For these services to be truly effective, it's crucial that frontline health professionals, such as GP receptionists, GPs and junior doctors in A&E departments, spot the symptoms of mini-stroke and refer patients for immediate specialist assessment. The Stroke Association's report reveals that a quarter of people (25%) said that healthcare professionals had not recognised their symptoms of mini-stroke, often dismissing them as just a 'funny turn'.
Taking appropriate action when a mini-stroke occurs relies on people knowing what symptoms to look out for. Initiatives, such as the FAST campaign, have helped to raise awareness of the symptoms of stroke, but much work is still needed. This is borne out by the Stroke Association's report - almost half (44%) of people taking part in the survey had never heard of mini-stroke.
The Stroke Association is right to turn the spotlight on mini-stroke and to highlight the dangers of rising obesity and diabetes rates, and unhealthy, sedentary lifestyles. There is also a need for more research. Stroke kills three times as many women as breast cancer, and twice as many men as prostate and testicular cancer combined. Yet, for every stroke patient, just £22 per year is spent on medical research in the UK, compared with £295 for every cancer patient. We urgently need to address this imbalance and make investment in stroke prevention and stroke research a priority.
To find out more about mini-stroke, visit www.stroke.org.uk/tia.Suggest a correction