Quick treatment of ministrokes cuts risk of major stroke later, studies find

Many patients are sent home within a day after a ministroke, experts say.

LONDON (AP) — Treating patients quickly for ministrokes could dramatically cut the risk of a major stroke later, report two studies that could change standard treatment and potentially save millions of people from stroke’s damaging effects.

In research published today, British and French doctors found that patients treated within 24 hours of having a mini-stroke cut their chances by 80 percent of having a more serious stroke in the next three months.

Such large reductions in risk are rare, said Dr. Peter Rothwell of Oxford University, lead author of a study published in The Lancet medical journal. “We normally get excited about 10 [percent] to 15 percent.”

Rothwell said that minor strokes should now be classified as medical emergencies. “The health-care system needs to be changed to respond to these people quickly,” he said. “The current delays in treatment in the United Kingdom are no longer acceptable.”

In the U.K., most patients who have small strokes are referred by their doctors to specialist clinics. Many wait several weeks before being treated.

In the United States too, many people are sent home within a day if their symptoms seem to resolve.

Worldwide, nearly 15 million people have a stroke every year, and it is one of the leading killers in the industrialized world.

Ministrokes, or transient ischemic strokes, have the same symptoms as a big stroke, including facial numbness, slurred speech, paralysis on one side of the body, blurry vision or a sudden headache. But in small strokes, the symptoms last less than a day.

Rothwell’s research was drawn from a larger population of nearly 100,000 people being studied for vascular disease. Of 1,278 patients who had a stroke or a mini-stroke, he and colleagues examined roughly 600 people who had ministrokes.

The British Stroke Association said that Rothwell’s study should lead to faster treatment of ministrokes.

“We clearly should not be evaluating stroke symptoms in a leisurely sort of way,” said Dr. Larry Goldstein, director of Duke University’s Center for Cerebrovascular Disease, who was not connected to the studies. “The main message from these studies is that treatment delays can be dangerous.”