TIA and Minor Stroke
Residual symptoms after transient ischaemic attack (TIA)
The symptoms of a TIA are similar to that of stroke, but they may only last a short while, certainly no more than 24 hours. If symptoms last longer than 24 hours but are mild usually this would be defined as a ‘minor stroke’. There was some confusion amongst some people we interviewed about whether they had actually had a stroke or TIA. The terms ‘TIA’, ‘minor stroke’ and ‘mini stroke’ were used by people to describe what they had experienced, based on the diagnosis they had been given by their GP or consultant.
Many of the people we interviewed recovered from their TIA or minor stroke and did not experience any continuing symptoms afterwards.
Phillip was fully recovered after a couple of days and says he was diagnosed with a TIA but he...
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And so they ran me through the most comprehensive testing mill. It was, I was there until 5.30. And by now the symptoms were gone.
And they explained what I’d had was a transient ischaemic attack, a sort of mini stroke, when a blood clot breaks away from some part of one of your veins and travels into your - it must be an artery - it breaks away from one of your arteries and travels into your brain and causes a blockage. This causes some damage to the brain cells, but the blockage gets re-dissolved and then everything recovered. And in my case the recovery was essentially complete.
The brain scans and the CAT scan didn’t find any problems. So everything had cleared up. There was no outward sign of any symptoms. My heart was fine and my brain seemed to be working fine. They did CAT scans and EGTs and all this kind of exciting stuff - ECGs, ECGs. And so it had all gone by then. Though there was still I think even 48, 36 hours later some residual symptom - which might still be here. And they claimed that this technically meant it wasn’t a TIA, because technically the TIA cuts off at 24 hours. If it’s more than 24 hours, it’s a full stroke. But they were very generous and let me in [laughs].
Adrian recovered completely from his TIA and feels that the fear he felt during the TIA itself...
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It was the most scary thing ever. Its, and I’ve had a heart attack and that scared me, but nowhere near as much as this TIA did. Because I really did think that was it, that I was going to lose my voice, my arm, all sorts. And it really was frightening to think that I could be left that way. And nobody was more relieved than me when the symptoms subsided and I began to function again. Because it really is a scary place to be.
It really is odd, because you don’t feel ill. You expect to feel something, but I felt absolutely nothing. I had no idea it was happening. One minute I was there. The next minute I wasn’t. It’s really is, I can’t emphasise how scary it was.
Is there any, are there any lasting at all or anything that’s stayed with you from that?
Physically there are absolutely no symptoms. No symptoms at all. The only thing that is staying with me is the fear. But I suppose I’m using that to my advantage because that’s now my inspiration and, and my drive to go to the gym to lose weight, to eat healthily.
Some people said that although they were not left with any physical symptoms, that the experience of having a TIA had left them feeling vulnerable or that they lost their confidence for a while.
John says he lost his confidence after being told hed had a TIA and sometimes now he feels he is...
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I think the strongest reaction was loss of confidence. That was a surprise, that all the thoughts and plans for the future were now jeopardised by what had happened. And that loss of confidence I think has continued, albeit diminished, for some months. So that’s something I’m aware of. And I feel less articulate than I would like to be. I find myself searching for words. Physically it’s made very little difference, very little difference. I still have strength, I have mobility. I’m not affected, to my knowledge, in any way in a physical sense. So all the, all the effects have been mental.
However, some people were left with some residual (on-going) symptoms that lasted a few weeks, and some people continued to experience some symptoms for a while afterwards. Commonly these included arm and limb weakness or numbness, slurred speech, memory problems, confusion and visual difficulties. In most cases the symptoms improved over time. Some people experienced just one residual symptom, whereas other people had a combination of different ones.
Some people whose initial symptoms included slurring of speech or forgetting how to speak normally found that afterwards they still had some problems. Some were offered speech therapy but not everyone was given this opportunity and some felt it would have been helpful.
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Frank's symptoms disappeared quite quickly and his speech problems lasted a few days but he says...
On the Monday. I mean, I felt fine on the Saturday. I mean, I was speaking not as, maybe not as well as this, even though this isn’t perfect. I mean, we went out in the evening to see some people, went to see four friends, you know, for dinner, and people thought I’d had maybe a rough day, which I may be had. So I wasn’t that bad, so it’s maybe more a TIA than a stroke. I mean, I really wasn’t feeling that rough. I could actually speak to people that evening, so that was twelve hours later.
I then went and saw the [research project] people and went through various things and had a whole series of examinations' a blood test, NMR - which they repeated after injecting I think some iodine to see where the problem was, which they located a speech problem. My speech had slowly got better over several days. My arm got better within a short time, but my speech carried on for - I mean, it got better over hours, but I’m sure it’s not as right as it was, actually.
As well as having speech problems, some people found that their short term memory was affected after the TIA or minor stroke, and for some people this meant they could sometimes become confused, not remember words, having difficulty with money or numbers, or just have a general feeling that things had not quite gone back to normal. For example, John said that he just felt that sometimes he wasn’t quite as articulate as he had been previously but he has no lasting physical symptoms and he continues his life as before. A few people took part in interviews with their partner because they still had some problems with their memory.
A few weeks after her TIA Yvonne still had moments when she seemed tired, confused or not quite...
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I mean, you know, a, a couple of weeks after it happened I was coming out of a charity shop I’d just been to, to take some stuff in and my husband said, “Oh I’ll wait for you outside” because I was chatting to the woman in there. And I came outside and all of a sudden my husband almost shook me. And I said, “Oh, oh what’s the matter?” And he said, “You looked horrible. Your face was blank, you didn’t actually know where you were. And you were just about to step into the road.”
And how, I mean, was this all around about the same time?
So it was over, over the course a few, a couple of weeks then …
..that it was still kind of feeling a bit weird?
And how long did it take for you to, I know you were feeling tired after that …
… but how long did it take for those kinds of sort of confused moments …
Probably three or four weeks.
… to go away. Really?
Some people continued to experience a sense of numbness or weakness in their hand, arm or leg afterwards and a few said it meant they were now less mobile than they had been previously. Sometimes people experienced occasional feelings like pins and needles, but weren’t always sure whether this was because of the TIA/minor stroke, or just normal pins and needles that you get after lying on your arm in a funny position. Physiotherapy helped some people to become more flexible and mobile again. Brian (Interview 08) said he now has a slight weakness in his left arm and leg but feels ‘it’s nothing to complain about really’. Like Yvonne (above) some people said that they still felt tired for some while afterwards.
Geoff still gets numbness in his arms and hands it was worse and it has improved but its not...
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Geoff' my main therapy was walking and …
Enid' Little bit of physio you had.
Geoff' A little bit of physio and they did like a rehabilitation where I had to go and, took me to, they have like a little …
Geoff' kitchen set up and I had to go and make some toast and brew a cup of tea …
If you laughing, did you find it …
Enid' Play house [laughs].
Geoff' No, I was OK doing that, the only problem is if, carrying anything. I mean, it’s affected this side of my body so presumably it was on that side of my brain.
And when you say it’s affected, in what way has it affected it?
Geoff' Well it feels as though, now, as though I’ve been laid on this side of my body and I’m waiting for the complete sensation to come back. Which, but I realise now that it won’t come back fully but I’m supposed to be on medication to help with that and it’s, it helps a little but I don’t have full control. I mean, I could perhaps, could carry a beaker of tea now but at times …
And that’s your right hand. Were you, were right handed?
Geoff' Yeah, that’s why it took me so long to fill that form in because I …
Right. Could have helped you if you’d said [chuckles]
Geoff' Because it, I mean, initially I couldn’t write at all. I mean, it was, no, my hand was going all over the place but now if I really concentrate I can write as you can see on the form.
Geoff' And it is more or less legible.
So there have been, it was worse and it has improved but it’s not fully back to how it was originally?
Geoff' It’s not fully back to how it was, no. Just, it just feels as though I’ve been laid on this side of my body and I’m waiting for the sensation to come back but I realise it’s as far as it will go now.
David has had help from a physiotherapist who has provided him with some mobility aids to help...
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As I say we’ve had the physiotherapist here who’s given me some, because I’d partially lost my balance, when I had the TIA. And I still use two elbow crutches now. So they provided those and she trained me how to use them. They put me a bar up in the bed so that I can heave myself out. I fall in [laughs]. But I can I heave myself out and hold on to it to help myself dress as much as I can because I’m a stubborn so and so. I like to try and do things as, as best I can myself. They provided me with an effort to put socks and pants on, and things, which is extremely useful.
They told me with my, my temperament being so well, no patience whatsoever, I’d never get on with it. But I got on with it like a house on fire from day one.
Rich still has weakness in his leg and he has to be more careful about what he does now
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I wanted to be out and active or I pottered around, you know, did this that and the other. I had one incident up there that kind of frightened me very much I was only talking to the physio about it this morning. I stepped down off something, and this is a stroke, and I stepped down onto the bad leg which just crumpled and I went whack on the bloody floor. These two fingers, I don’t know what they hit, became as big as sausages. I got in the car and it’s only a couple of miles away, got in the car, came back here and sat down and I walked through the door and [wife]said, “What have you done?” And I just collapsed in tears. I was this colour.
Shock. And from that day to this day I don’t go up anything, a step-ladder or, well step-ladders, steps or anything…
Do you still have some …
… without somebody …
... being …
... being there, yeah.
Do you still have some weakness in your arm and leg?
Yes, yeah and this is funny enough has come out today when I went and the, fortunately I got the physio who actually worked with me in [name] ward. I found out she was actually in the outpatients physio and I was talking to her today and she said, “You are still weak, Rich. Your core, your core fitness here is out of balance, the back to the front”. Because I’ve had back trouble. And she said, “It will help your left leg” because occasionally left foot, I can trip.
So you have to be a little bit more careful and...
I have to be very, very careful with what I do, you know. I’m not totally whoa, like this, you know. I can go and play golf but there are certain things I have to be careful … I cannot, I mean, if I come in from outside and it’s wet, I can’t wipe my feet.
I can’t do it, a little kind of, you know, how you wipe your feet, I can’t do that.
So, it’s making a few adjustments to how you …
Few, yeah …
.. deal with things?
.. I have to be careful what I do. There’s not very many things I can’t do but, you know, I just have to be careful take a bit of time.
Most people who had experienced visual disturbance recovered completely afterwards. One man said his eye-ball coordination was not what it was, and another was told he must no longer drive the car because his sight had been affected and was no longer good enough for driving.
Geoff has been told by the optician that his eyesight has deteriorated and he can no longer drive...
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Geoff' About my, my vision? Well I, I was going up to the optician and up at the hospital and they were , they were doing the visual field test and realised that I had this problem and said it probably won’t get any better. But now normal, you know, normal living I don’t seem to have any problem with my eyesight. And this is, this is why it gets me so upset really.
And so at that, at what point did you surrender your driving licence? And did somebody tell you, you had to do that? What happened? How did it come about?
Geoff' Well, obviously I couldn’t drive after I’d had the stroke and I was asking the doctor when I could drive and he said, “Well it’s all, it all depends on your, on your eyesight.” He said, “So, they’ll be, you know, they’ll be doing the, the eyesight tests and you’ll have to wait for the results of those.”
Geoff' the last time I went to the optic, my own optician, I mean, I don’t know whether you’ve, have you ever been to an optician and had the field test. And the last time I went to have my eyes tested she said and they go through the test, they said, “You haven’t done the field test,” she said, “I won’t need to because it won’t be any different than it was before.” [laughs].
Enid' So that’s more or less saying it won’t improve.
Two people said that they had been told that they had some residual brain damage. This came as a surprise to both of them because they thought that brain damage would be associated with a more major stroke.
Clare was told that there was a small area of brain damage that was permanent, but she told her...
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It was a TIA. But the thing is that I was left with brain damage so that was where it was sort of like, because I did recover very well but I was left with a small patch of brain damage to which I was extremely, I took very, very badly. You know.
And what’s the outcome of that then in terms of the future for, is that something that’s going to improve or that’s permanent?
I feel that, I mean, it’s permanent damage because it’s brain damage but I feel that other parts of my brain have compensated because how I was then to how I am now… I said to friends on the weekend that I was doing this interview with yourself and the fact that, you know, I felt that I, the way I was before I had come back if you like.
And do you remember how, what, what the doctors or whoever it was that gave you the diagnosis, I mean, how did they distinguish between a TIA and a full blown stroke?
Because they, because it had happened within a certain amount of time.
And because it had happened within 24, I’d recovered within 24 hours they put it down to a transient ischemic attack.
Yvonne wasnt happy with the way her doctor casually mentioned that she had some brain damage and...
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I went in on Thursday, spoke to the specialist who at the hospital who was very good, very reassuring and said, “No, I don’t think it I think, don’t think you’ve had a stroke, I think you’ve had an episode.” And that’s the first time I’d kind of heard the word stroke, which was a bit of a shock. And anyway so he arranged for me to have a, a, a brain scan, but said we had to wait, because I hadn’t sought medical attention immediately we had to wait so that if there was any swelling or bleeding or whatever it, it had gone down.
So I came home and said to my husband, “Oh, it’s fine, you know. It’s, it’s nothing to worry about.” Started to get exceedingly tired but then I’d been complaining about tiredness before, because I’d previously been diagnosed with a heart condition. So thought, “Oh, it’s just all part and parcel really.” Then I went and had my brain scan which obviously showed up that I had had a stroke and I must admit I was, I wasn’t happy with the way I was told wasn’t the same consultant that I’d seen previously. He started going through my scan pictures on the computer with his back to me and then said “Oh if you look here, that’s the damage, that’s the damage to your brain, that’s how we can tell you’ve had a stroke.” And, “Have you got any questions?” And at that stage I thought, “Gosh I’m sure I’ve got thousands of questions but I’m, I really can’t think of any right now.” My husband asked a few questions about driving and, and stuff like that. And anyway then I came home, burst into tears and said, “I don’t believe this has happened.” You know, “I’ve gone from being Mrs Superfit, to being diagnosed with a heart condition to now having a stroke. All within 18 months.” You know, I’m really not coping with it at all.
It felt as if he was almost dismissive as if it was a very minor thing and, you know, kind of, “I don’t know why you’re really bothering us with it.” It felt, and I said to my husband afterwards, I said, “That’s actually quite a major thing in my life now, you know, going with everything else that’s happened over the last, you know, 18 months,” I said, “and to tell me as if he telling me as if I had a, a cold…” I mean, obviously he comes across it all the time and he comes across far more serious cases, and I understand that, but I just feel that he could have been a little bit more subtle in the way that he told me.
Just to actually point at a picture of my brain and say, “Well, there’s your brain damage and that’s how we know that you’ve had a stroke.” You know, you mention brain damage and people think, “Oh my God, you know, what, what brain damage?” You know, because brain damage to you means somebody who can’t, you know, perform certain functions of things. And, you know, just to actually say, well actually it’s, it will repair itself, there wasn’t any of that, you know.
A number of people said that having a TIA or minor stroke had affected their emotions and that they were now more prone to becoming upset about trivial things, or that they sometimes felt angry or became more upset about small things than they would have done previously and some people found that they experienced feelings of depression for some while after their ‘event’. Several people felt quite emotional when they were talking to the researcher about what had happened to them and became tearful even though they said they were usually not the kind of person who cried easily. A few people felt that for a time afterwards they had lost their confidence and felt ‘lost’ (see ‘Emotions and feelings’).
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George sometimes feels depressed and has lost confidence in himself since his TIA
Now since then my memory is poor. I get very, very depressed. My confidence is gone. That’s one of the worst things. If for instance, how can I say? If I was going to drive more than eighty miles, I feel I don’t want to do it by myself just in case anything happened to me. And that should never be. I don’t like going for a walk without taking a mobile with me. It’s on your mind all the time because I had no warning of either of my strokes whatsoever. No pain or anything, it just, it just happened. And believe me that is absolutely scary, really, really scary.
I get very short tempered. I must admit with my wife, I do get very, very short tempered with her. It’s just frustrating, absolute, pure frustration. I then, at times I just can’t be bothered. I just can’t be bothered anymore and I shouldn’t be like that,. I’m only seventy seven. I can walk from here to [local town], no bother, no problems at all. I mean, I feel, extremely fit.
Last reviewed June 2017.