Businessman Sam (not his real name) was driving home when his left arm suddenly dropped from the steering wheel and he lost vision in his left eye.
“All of a sudden, I could not remember where I was going. I panicked and stopped by the roadside to rest for a few minutes. After a while, things slowly got back to normal.”
Worried, Sam consulted a doctor who diagnosed it as a transient ischemic attack (TIA) or mini-stroke.
“The doctor told me that TIA can serve as a warning, as well as an opportunity — a warning of an impending stroke and an opportunity to take steps to prevent it from recurring.
“Be careful if you have suffered such an attack and get medical help immediately,” Sam advises.
Datuk Dr Raihanah Abdul Khalid, consultant neurologist of Assunta Hospital says: “TIA is caused by a blood clot. The difference between a stroke and TIA is that with TIA, the blockage is temporary and resolves itself in a short time.
“TIA usually lasts less than an hour. Most attacks last between five and 15 minutes. When it is over, it causes no permanent injury to the brain,” she said.
However, Dr Raihanah says TIA should be regarded as a serious warning because it signals that the patient is at a high risk of a major stroke.
“In fact, one in three of patients with TIA has a stroke within a year. If you have suffered a TIA, see a doctor immediately to start medical treatment. The main aim is to identify the risks (factors), treat them and prevent a stroke.”
Most people are aware of FAST, which is an easy way to remember the signs and symptoms of stroke. The acronym stands for facial drooping, arm weakness, speech difficulties and time.
“Medical experts say we should add the letters E and R to the acronym, which means FASTER. The letter E stands for eye symptoms. A stroke is a brain disturbance, where you lose motor function, vision and speech.
“Most people do not realise that a vision problem can be sign of an impending stroke.
“For example, a transient visual problem (blurring, double vision and loss of vision in one eye). You can have a stroke with just one symptom. While most TIA symptoms revolve around speech problems, 30 per cent (of TIA patients reported having) vision problems,” says Dr Raihanah.
“The letter R stands for react now, do not wait and do not delay. Anything that happens suddenly should alert us to a problem with the brain. TIA can happen to anyone in any age group.
“We are seeing it happening to those who are in their 30s and 40s because of diet, lifestyle and stress. This is why it is important for people to go for regular medical check-ups,” she adds.
Dr Raihanah says the prevalence of diabetes and obesity is very high in Malaysia.
She says in the United States, a person needs to have a body mass index (BMI) of 30 to get diabetes, but in Malaysia, a person with a BMI of 25 could get diabetes.
“Somehow, we are more sensitive.
“Smoking and hypertension are the top two risk factors for TIA and stroke. Another factor is atrial fibrillation (irregular heartbeat), which increases the risk of stroke and TIA by seven per cent.”
Dr Rishikesan Kuppusamy, consultant neurologist, Pantai Hospital, says common risk factors for stroke or TIA are hypertension, diabetes, high cholesterol and smoking.
“If the cause is not clear, we will extend our investigation by looking at the heart.
“Stroke and TIA can also be caused by cardiac problems like atrial fibrillation or abnormalities of the heart valve. TIA can also happen to patients who have had a heart attack or stroke.”
“Special causes of stroke and TIA are seen in cases where people have a genetic tendency to develop blood clots, or those who are born with genes which make their blood thicker.
“Neck injuries caused by (physical) trauma or aggressive neck massage can also cause stroke or TIA.
Dr Rishikesan says the most common symptoms of stroke are slurred speech, loss of control on one side of the body, severe giddiness and vomiting, facial drooping, double vision or blurred vision. It is a one-sided neurological disturbance.
“It is important (for the person) to get to a hospital immediately for medical attention to determine if he is experiencing a stroke.
“Time matters as a drug can be administered in the golden window of three to 4½ hours to dissolve a blood clot.”
Once the causes of TIA are discovered, the patient will need to change their diet, adopt a healthier lifestyle, stop smoking and take medications that doctors have prescribed for him.
“Patients who have had TIA are treated exactly like those who have had a stroke. We advocate (patients) to adopt a healthy lifestyle, to not develop diabetes, keep cholesterol level and blood pressure in check, and take medication if they have been diagnosed with conditions associated with stroke, like diabetes and hypertension.”