National Stroke Awareness Month: warning signs, ministrokes and seeking medical care

Posted: 18/05/2020

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May 2020 is Stroke Awareness Month. More than 100,000 strokes occur in the UK each year – this is around one stroke every five minutes. 

This article focusses on transient ischaemic attacks, often called TIAs or ministrokes. A TIA may sound less serious than a stroke, but it is often a warning sign that there is a problem which needs urgent medical attention.

The main symptoms of a TIA are the same as those of a full ischaemic stroke. (An ischaemic stroke is caused by a blood clot stopping the blood supply to the brain.) The onset of symptoms in a TIA is usually sudden. The key difference between a TIA and a full stroke is that in a TIA, the symptoms disappear - sometimes in as little as a few minutes or a few hours. The main danger of a TIA lies in ignoring it.   

Everyone reacts differently to a TIA and symptoms depend on what part of the brain is affected. However, the three most common signs of a TIA or a stroke are easily recalled by using the acronym FAST:

• Face – can the person smile? Has their face fallen on one side? Has their mouth or their eye dropped on one side?
• Arms – can the person lift both arms and keep them raised? Do they have weakness or numbness in one arm?
• Speech – can the person speak clearly? Is their speech garbled or slurred, or are they unable to speak at all even though they appear to be awake? Does the person understand what is being said to them?
• Time – if any of the above three signs are present, medical help needs to be sought immediately even if the symptoms pass or improve suddenly.

Other symptoms include dizziness or visual problems such as blurred or loss of vision.

When symptoms first start, there is no way of knowing whether the individual is having a TIA or a full stroke. It is important to remember that a TIA is temporary and, once it is over, it will seem as though there has been a full recovery. This can (and frequently does) lead to the individual concerned deciding that what happened was not a medical emergency. According to a 2014 survey by the Stroke Association, more than one in three TIA patients had dismissed their symptoms as just a ‘funny turn’. The same survey showed that 20% of these individuals subsequently went on to have a major stroke.

A recent BBC article reported that A&E visits in England have halved since the coronavirus outbreak began and there is particular concern that those who have suffered strokes and heart problems are staying away from A&E. The clinical director for strokes at NHS England, Dr Deb Lowe, is quoted in the article as saying that she and her fellow doctors were “really worried” that the numbers seeking help for stroke care had gone down. 

Camilla Wonnacott, an associate in the clinical negligence team at Penningtons Manches Cooper, said: “There are growing concerns that, in the current pandemic, those suffering from stroke symptoms may be tempted not to seek help; when the symptoms do not last very long, it may be even more tempting to dismiss them. Lack of proper investigation into transitory stroke symptoms can have devastating consequences where the individual can then go on to suffer a full stroke.”

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