Alarming Signs and Precursors to a Mini-Stroke

“My stroke (TIA) story.”

“Looking back and talking to my wife about that moment, she said that she thought I was doing a Walter White Jr/RJ Mitte (From Breaking Bad) impression to embarrass her. Anyway, after I collapsed (I actually fell into some woman, but she was fantastic and called the ambulance and things for us), I sat on the floor with my wife propping me up, and the entire left side of my body and face was limp. As soon as this happened, the first thing that came to mind is the UK’s NHS Act F.A.S.T. campaign and I knew exactly what was going on… It was odd, me having this realisation, quietly, while unable to speak, but while all those around me were panicking… It was somewhat surreal.”

Numbness or Weakness

One of the hallmark symptoms of a TIA is the sudden and often alarming onset of numbness or weakness, frequently affecting the face, arm, or leg. This peculiar sensation typically manifests itself on one side of the body, rendering it difficult for the individual to perform even basic movements or control the affected body parts effectively. This abrupt and unsettling loss of motor control is not merely a cause for concern but rather a glaring red flag that should not be underestimated in any way. It serves as a stark indication of the potential interruption of crucial blood flow to specific areas of the brain, thereby leading to these disconcerting neurological symptoms.

“I had a mini-stroke/TIA the other day”

“Well, the title says it all. The constant stress during the pandemic manifested itself in a mini-stroke/transient ischemic attack. I did my usual morning routine of feed cats, have coffee, do online course updates and workout, and after my workout my left arm went numb and I felt panicked and disoriented. I thought I was having a heart attack so I called 911. I was home alone since my husband had already left for work. So, I spent a day and a half in the hospital, had lots of tests that fortunately were good news, got excellent care, and I have to start some medications. The overall prognosis is good. With medications, this may never happen again, but without I’d be high risk for a major stroke.”

Difficulty Speaking or Understanding Speech

During a TIA, individuals may experience considerable difficulty in speaking clearly or comprehending speech, a phenomenon that can manifest as a pronounced slurring of words or the profound inability to articulate their thoughts coherently. This incapacitating symptom can be profoundly alarming, not only to the person undergoing this ordeal but also to those in their immediate vicinity. It is paramount to recognize and underscore the gravity of this impairment as a potential harbinger of a TIA. This symptom underscores the direct involvement of the intricate brain regions responsible for language and communication, and its sudden onset should act as a clarion call for an immediate and unwavering response.

“How long did you take to recover from TIA?”

“It’s been over a week now, almost 2. My doc thinks it could take me 2 to 3 weeks to recover. It’s terrible, my right arm and leg still give me the most trouble with pain and mobility and the occasional left over tingles. My right side of face is still dropped a lil. This really sucks. I’m so mad at myself I initially ignored the war no NG signs due to being in chronic pain with lupus and heart failure. (I also have an aortic aneurysm.) I have moments were I feel, ok I’m getting better, then when the ibuprofen wear off, I feel back to square one. I was also out on emergency BP meds, as it keeps crashing and then shooting sky high and not coming down. (I hate u heart failure!) when mine happened I could not read or understand anything. Among other usual symptoms. Ugh. I get. So. Mad at myself. We are hoping I fully recover. But I keep reading abt so many recovering quickly, I’m a slow healer.”

Vision Problems

What makes vision issues particularly significant is their direct link to the disruption in blood flow to the brain regions responsible for processing visual information. Essentially, the eyes act as the windows to the brain, and any irregularities in visual perception during a TIA should not be brushed aside. To delve deeper, these visual disturbances occur because the brain’s visual centers temporarily experience reduced blood supply. This reduced blood flow disrupts the intricate neural networks responsible for interpreting visual cues and relaying them as coherent images. Consequently, individuals undergoing a TIA may perceive their surroundings as hazy, disjointed, or even go through moments of darkness when their vision is temporarily impaired.

“Young guy (33) just had a TIA”

“I don’t smoke, hardly drink, don’t do drugs and the like. I had a TIA back in 2013 when I was 28. After lots of testing and such, it seems like it was likely due to a PFO. I had a week long headache where nothing tasted right, then suddenly I collapsed with complete left-hand side paralysis. It happened exactly a month after getting married. After an MRI, they discovered a number of old, healed lesions along with the nice new ones. It seems I was having very minor TIA’s over the years and just mistook them migraines. After the bigger one, I have a few very minor physical deficits. A couple of patches on the left side of my neck and head that have unusual sensation. Sort of simultaneously reduced and increased sensitivity. Cognitively, I thought I had some kind of memory issue and short term memory seems… Off.”

Dizziness and Loss of Balance

These symptoms are closely tied to the brain’s intricate control over balance and spatial orientation. Normally, the brain relies on a complex interplay of sensory information from the inner ear, visual input, and proprioceptive feedback from muscles and joints to maintain equilibrium and coordinate movement. However, during a TIA, this delicate balance is disrupted due to a temporary compromise in blood flow to specific brain regions responsible for these functions. Consequently, individuals may find themselves struggling to maintain their footing and may experience an exaggerated sensation of unsteadiness. This compromised spatial awareness can lead to unexpected stumbles, trips, or difficulty in coordinating their movements, which, in turn, can pose potential dangers such as falls or accidents.

“Redditors who have had a stroke, what does it feel like?”

“I had a “mini-stroke”, or transient ischemic attack (TIA), in 2004, at age 40. Blood clot presumably blocked an artery in my brain. Couldn’t speak or write for 4 hours. No pain, but very frightened and weirded out. The ER doc didn’t believe it could be a stroke, so I didn’t get clot-busting drugs or an MRI or CT scan right away, which you should. (This was 9 years ago; the protocols are better now.) I dozed off while waiting for the doc at one point a few hours in; when I woke up, which was about 4 hours after things started, I could speak again. Never had any trouble since.”

Confusion and Memory Problems

These cognitive alterations can encompass a spectrum of experiences, including confusion, memory problems, and difficulty in processing and understanding information. While these cognitive shifts during a TIA may not always be glaringly apparent, their subtlety should not diminish their significance. Even seemingly mild lapses in cognitive function can have meaningful consequences, as they can impact an individual’s ability to carry out routine tasks and communicate effectively with others. Simple activities like preparing meals, driving a vehicle, or engaging in conversation can become challenging when cognitive functions are compromised, regardless of the degree of subtlety.

“My Mom had a TIA stroke. Need some advice”

“My Mom was acting a little weird recently so we took her to the hospital and found out she had a minor stroke (TIA) and she also had type 2 diabetes. She is going to physical therapy because it’s mainly her right hand and right leg that are suffering the most. Her emotions have been out of whack which we’ve been working with, but know it’s something we’re going to have to work with and something that cannot really be controlled. She used to be a very busy person, always running around and since she’s not driving now, she has little motivation to do anything at all, puts everything off, pretends some things don’t exist and just sits on the couch most of the time and watches TV and plays on her iPad. ”

Difficulty Swallowing

Difficulty swallowing during a TIA occurs when the normal coordination of muscle movements required for swallowing is disrupted due to a temporary interruption of blood flow to specific brain regions. This disruption can lead to the sensation of food or liquids getting stuck in the throat, making the act of swallowing uncomfortable and challenging. Moreover, difficulty swallowing during a TIA can also result in an increased risk of aspiration, where food or liquid enters the airway instead of the esophagus, potentially leading to choking or respiratory issues. This symptom can significantly hinder an individual’s ability to maintain proper nutrition and hydration. Prompt recognition and medical evaluation are vital not only to address the immediate concern but also to identify and manage the underlying vascular issues that may increase the risk of further neurological events.

“I’m only 34 and would like to know if I’m alone going through this”

“I had a stroke a month ago too. Im 37. I got out of the hospital a few weeks ago. I have not regained sensation on the left side of my body but I am mobile. I go to occupational and physical therapy a couple times a week. I have random emotional outbursts and everything still sounds “off”. I have been working on Lego sets to keep my hands and mind busy. I’m starting therapy with a counselor who specializes in traumatic brain injury. I don’t feel like myself and the depression has been tough. The legos help me a lot. ”

Tingles or “Pins and Needles” Sensations in the Limbs

These sensations are often perceived as an uncomfortable prickling or tingling, akin to a limb “falling asleep.” Such symptoms typically manifest in the extremities, such as the hands, fingers, arms, or toes, but they can occasionally affect other body parts. These sensory disturbances are a direct result of the TIA’s primary characteristic: a temporary but critical disruption in blood flow to specific regions of the brain. In the absence of adequate blood supply, the affected brain cells become deprived of oxygen and essential nutrients. This oxygen and nutrient deficiency, in turn, affects the proper functioning of the neurons responsible for transmitting sensory signals. While pins and needles sensations might seem innocuous, they should never be disregarded during a TIA.

“I 26f had an ischemic stroke….. really confused, scared and not sure what to do now”

“I’m 26 and I had an ischemic stroke 5 days ago. Now I’m left with so many questions, a lot of fear and just wondering why this happened. The night before I stayed up all night reading and I had a light headache around 4am but I get headaches from time to time and I could barely feel that I figured I could sleep it off. I remember feeling this weird zap in my head that made me stop eating the candy like maybe that was too much sugar and I stood up to head to the bathroom and my movement was uncoordinated, I bumped into some shoeboxes and I was SO confused by that, I don’t just knock into things. So I got on my knee and picked up what fell and when I tried to get up… I kept coming down to my knee. I got my phone, I contacted my mom saying I didn’t feel well, and she told me to call 911. I did that, gave them my info. I was conscious, speech was fine, reasoning capabilities also fine. It was just the left side weakness and numbness that I noticed. I made it downstairs and on my porch when the ambulance arrived.”

Unexplained, Temporary Loss of Consciousness

This symptom involves a sudden and unexpected episode where an individual loses consciousness for a brief period, usually lasting just a few seconds or minutes. Unlike fainting or syncope, which may have discernible triggers or causes like dehydration or low blood sugar, unexplained loss of consciousness during a TIA can occur without any apparent reason. It can lead to falls, accidents, or injuries, depending on the circumstances. This symptom may be accompanied by confusion or disorientation upon regaining consciousness, adding to the distress of the episode. It should never be dismissed or attributed to simple fatigue or other benign causes, as it can be a precursor to more severe strokes.

Weeks Long Recoveries

“I stopped having pain after ~6 weeks. Took me ~5 months to get my complete balance and mobility back. 9 months till I could see straight again. My vision was the only part of my recovery that frustrated me. I’d take a leap forward. Within a few hours I would involuntarily take a step back for a few days. Followed by a leap forward. Repeat. It takes time. Don’t get frustrated. Dive into spending time with your family and pursuing your hobbies.”

Nausea or Vomiting

Nausea during a TIA can manifest as a persistent feeling of queasiness, stomach discomfort, or even a strong urge to vomit. For some individuals, vomiting may occur as a result of this heightened gastrointestinal distress. These symptoms are often unexplained, as they may occur without any apparent connection to dietary factors or other typical causes of nausea. Beyond the physical discomfort, nausea and vomiting during a TIA can also contribute to additional challenges during the episode. For instance, they may exacerbate feelings of weakness and confusion, making it even more difficult for individuals to respond effectively to the TIA’s neurological symptoms.

“hey /r/neuro! Has anyone ever heard of a transient ischemic attack (mini-stroke) in a healthy young adult?”

“Yes, TIAs are documented in essentially every age group. From the literature, “[a]pproximately 10% to 14% of ischemic strokes occur in young adults.” And that’s not considering elevated risk groups, like those with Fabry’s. As an anecdotal aside, I had one when I was 24 and in graduate school. My right hand went numb up to the elbow, as did my lips, nose, and surrounding parts of the right side of my face. I went to the ER or the medical school where I was studying, and the ER doctor essentially laughed it off as if I had imagined it. I went to my primary care physician the next day who took me more seriously, and ordered a round of MRIs and other imaging / screening exams. I had a terrible headache for months afterward, and for several years I would have an occasional migraine with auras, but nothing we looked at seemed to show lingering risk or complications, so I slowly got back to my usual routine. As a precaution, I’ve since been vegan and followed a diet that lacks any refined oils (per the Cleveland Clinic’s heart disease intervention diet, as popularized by Dr. Caldwell Esselstyn).”

Fatigue or Sudden Onset of Extreme Tiredness

Fatigue during a TIA often presents as an overwhelming sense of tiredness that is both sudden and profound. Individuals may feel an extreme and unexplained need to rest or sleep, regardless of the time of day or their prior level of activity. This sensation of fatigue can be different from ordinary tiredness or exhaustion, as it is not typically preceded by strenuous physical or mental exertion. These interruptions can affect the brain’s capacity to maintain wakefulness and focus, leading to a sudden onset of extreme tiredness. Beyond the physical sensation of tiredness, fatigue during a TIA can significantly impact an individual’s cognitive and physical capabilities. Concentration may wane, and tasks that require mental clarity and decision-making can become challenging. This symptom can also lead to impaired motor skills, making it difficult for individuals to perform everyday activities effectively and safely.

Facial Drooping, Particularly on One Side of the Face

When a TIA occurs, the affected area of the brain briefly receives inadequate oxygen and nutrients, leading to a transient impairment in motor function. This can manifest as the sudden drooping of one side of the face, creating an asymmetrical appearance. It often affects the muscles responsible for controlling the eyelid, mouth, and facial expressions, leading to an observable change in an individual’s facial symmetry. Facial drooping during a TIA is more than just a cosmetic concern; it signifies a disruption in the brain’s neural circuits that control precise muscle movements. Individuals experiencing this symptom may find it challenging to smile or close their eyelid on the affected side. It can also lead to difficulties in speaking, eating, and maintaining normal facial expressions.

Where Do We Find This Stuff? Here Are Our Sources:

https://www.cedars-sinai.org/health-library/diseases-and-conditions/t/transient-ischemic-attack-tia.html

https://www.ninds.nih.gov/health-information/disorders/transient-ischemic-attack-tia

https://www.stroke.org/en/about-stroke/types-of-stroke/tia-transient-ischemic-attack

https://www.stroke.org/-/media/Stroke-Files/Lets-Talk-About-Stroke/Life-After-Stroke/Lets-Talk-About-Stroke-and-Vision-Sheet.pdf

https://www.stroke.org.uk/effects-of-stroke/physical-effects-stroke/balance-problems-after-stroke#:~:text=A%20stroke%20often%20causes%20weakness,the%20ground%20when%20you%20step.

https://www.stroke.org.uk/effects-of-stroke/memory-and-thinking#:~:text=Problems%20with%20memory%20and%20thinking%20(cognitive%20problems)%20are%20very%20common,and%20weeks%20after%20a%20stroke.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066736/#:~:text=Dysphagia%20affects%20more%20than%2050%25%20of%20stroke%20survivors.&text=Fortunately%2C%20the%20majority%20of%20these,remain%20dysphagic%20after%206%20months.&text=One%20study%20reported%20that%2080,alternative%20means%20of%20enteral%20feeding.

https://www.stroke.org.uk/what-is-stroke/when-someone-is-seriously-ill-or-dying-after-stroke#:~:text=The%20most%20severe%20strokes%20can,the%20person%20may%20not%20survive.

https://www.flintrehab.com/stop-vomiting-stroke/

https://www.stroke.org.uk/effects-of-stroke/tiredness-and-fatigue#:~:text=It%20can%20happen%20after%20any,be%20mild%20or%20more%20severe.

https://ohns.ucsf.edu/facialnerve/how-tell-difference-between-bell%E2%80%99s-palsy-vs-stroke

http://www.nhs.uk/actfast/Pages/stroke.aspx

https://www.reddit.com/r/Professors/comments/imrgc4/fk_i_had_a_ministroketia_the_other_day/

https://www.reddit.com/r/stroke/comments/lzl5lk/how_long_did_you_take_to_recover_from_tia_mini/

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/magnetic-resonance-imaging-mri#:~:text=What%20is%20MRI%3F,large%20magnet%20and%20radio%20waves.

https://www.webmd.com/pain-management/what-is-physical-therapy

https://www.reddit.com/r/stroke/comments/affoiu/i_26f_had_an_ischemic_stroke_really_confused/