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Mini brain attack – a friend or foe?

As the master organ of the body the brain controls every single thing we do. From all motor movements to our ability to think, sense and feel, nothing is possible without the brain, A brain attack is a sudden loss of brain function due to deranged brain blood circulation. It is a life threatening condition. Even if a patient survives a large untreated stroke, lifelong disability will cripple his life.

A brain attack is identified by sudden:

  1. Arm or leg weakness
  2. Loss of sensations (numb) on one of body
  3. Seeing problem in one or both eyes (vision)
  4. Loss of balancing/walking difficulty
  5. Understanding and speaking difficulty
  6. Dizziness
  7. Worst ever headache of life

The symptoms can be remembered easily by a mnemonic BEFAST – which stands for Balance, Eye sight problem, Face droop, Arm weakness, Speech problem, Time to reach ‘stroke ready’ hospital.

The larger the stroke, the more will be the symptoms occurring together. Small strokes are characterised by fewer number of symptoms. Immediate identification of a brain attack is important, as ischemic strokes can be treated.

A clot blocking a brain blood vessel can be dissolved using clot bursting drug or it can be removed using cath lab procedures. In either case, earlier the treatment, the more the chance of a patient recovering completely.

A mini brain attack is a condition where one or more symptoms start suddenly, but may last only for a few seconds/minutes/hours, followed by progressive recovery of symptoms. In fact, some times the symptoms may completely disappear within 24 hours.

Is it a friend?

In a way yes, because a mini brain attack causes almost no damage and the symptoms improve completely without any treatment. This is unlikely in a large brain attack.

Is it a foe?

In a way, yes as well! The mini brain attacks are sometimes so mild or short lasting that the symptoms are ignored by the patient or dismissed as just one of those normal variations in health condition. However, these mini attacks can be a warning sign of a large impending stroke. These patients will be at a higher risk of suffering such a stroke in subsequent weeks. Such patients need to visit the hospital on an emergency basis. They need to be investigated similar to a patient with a large brain attack. If properly evaluated and treated in time, treatment can be initiated immediately to significantly reduce the risk of strokes in the future.

Sometimes, patients may have a blocked brain artery, which needs either an open surgical operation to remove deposited fat or keyhole endovascular stenting procedure within hours in order to prevent a large brain attack. The risk factors for brain attack and mini brain attack are same. If all these risk factors are appropriately identified and treated, it can not only prevent strokes but also reduce the risk of heart attacks significantly.

In an emergency setting, patients with on-going symptoms of mini brain attack may need emergency clot bursting treatment in a ‘stroke ready’ hospital. Hence, it is crucial that the patients reach the right hospital, that is a ‘stroke ready’ hospital as soon as they can. Reaching a small small hospital with limited expertise and facilities is unlikely to help.

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