TIA and Minor Stroke

Delay in getting help for a transient ischaemic attack (TIA)

Getting an early diagnosis and treatment after a TIA is very important, as it reduces the risk of a further TIA or a stroke. There are two main reasons why people may experience a delay in getting treated' either because they do not realise the significance of the symptoms, or because health professionals do not act quickly enough.

People we talked to often found it difficult to know when or whether to seek medical help during or after the onset of symptoms. In many cases the symptoms only lasted a short while and it could be easy to pass them off as being insignificant. Some of the people we interviewed suggested men were sometimes more likely to dismiss symptoms as trivial and less likely to seek medical attention especially where they seemed fairly short-lived.
 
Often, symptoms such as headaches, general dizziness, or momentary blurred vision could be felt to be something less serious, just one of those things that we all get from time to time, especially in older age.
 
Sometimes people didn’t mention their symptoms to their partner or family to avoid worrying them.
 
Some people remembered experiencing small or seemingly trivial symptoms before having a TIA, which at the time they had thought nothing of and had not reported their symptoms to anyone. Geoff felt upset that his TIA could not have been predicted, but realised later on that he may have had warning signs that he had ignored.
 
A lot of people we spoke to were unaware of the symptoms of stroke and did not therefore associate their own experiences as being related to that (see Understanding of TIA/minor stroke’). People were more aware of symptoms such as numbness or paralysis and speech loss, but visual disturbance and feelings of disorientation did not seem so important.
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It could also be easy to attribute symptoms to something else entirely, such as medication. Yvonne had been recently prescribed medication for a newly diagnosed heart condition and so thought that her symptoms must be side-effects. Like Yvonne, some people felt that they didn’t want to bother the doctor over something that seemed to pass relatively quickly.
 
Several people said they felt reluctant to ‘bother’ the GP and so waited to mention their symptoms until they had a routine appointment for another matter. In Yvonne’s case, after mentioning her symptoms to her GP during an appointment for something else, there was a further delay in seeking help as she was referred to a TIA clinic but did not know what it was.
 
Two people talked about experiencing symptoms whilst travelling by plane returning from abroad. Both of these people felt that they just wanted to get home and decided that they would rather make an appointment to see the doctor later. In Ken’s case, this was partly because he thought that if the air cabin crew knew that he was feeling unwell they would stop him from continuing his journey home.
 
Often it was a partner or carer who expressed concern and initiated a call to the GP or emergency services, but it could be difficult sometimes for other people to make the decision as to what to do.
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Sometimes people did seek help but for one reason or another did not get seen as quickly as they might have been. This could be because their symptoms occurred out of GP surgery hours, or they may have phoned their surgery for an appointment but were given a routine appointment (not immeadiate) rather than an urgent appointment. Roger felt that the receptionist at his GP practice should have responded more appropriately to his request for an appointment with his doctor, and eventually he rang NHS direct for advice, and was told to go straight to A&E to be seen urgently. Similarly Mike’s episode (below) occurred in the evening when the surgery was closed, and when he saw a locum doctor from the ‘on call’ service he was told to go and see his GP in the morning rather than being given immediate treatment. With hindsight he feels more urgency might have helped.
 
Some GPs did not immediately recognise symptoms, and put it down to some other cause such as anxiety or an infection.
 
One woman was taken straight to A&E by her colleague after collapsing at work where an emergency doctor said he thought she’d had a TIA and advised her to see her GP as soon as possible. However, although she followed the advice, her GP subsequently referred her to a general triage clinic that dealt with unexplained symptoms rather than to a TIA clinic. Eventually it was felt that she needed to see a neurologist, and she is now still waiting for an appointment several months later.
Sometimes people were referred quickly but still did not quite register how important it was to be seen quickly.


Last reviewed June 2017.
Last updated June 2017.

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