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Should mini strokes be treated with aspirin?

Researchers recommend that mini strokes should be treated immediately with aspirin

Published:

A review of existing evidence, published in The Lancet, found people treated with aspirin after a mini stroke (transient ischaemic attack, or TIA) were less likely to experience a more serious follow-up stroke.  This advice is under review by the NHS, who strongly recommend getting medical help immediately by dialling 999.

A TIA occurs when a blood clot temporarily blocks blood flow in the brain. It causes problems including numbness or weakness of the face, arms or legs, as well as dizziness and problems with speech and sight.

These usually pass quickly, but are a warning sign of the possibility of a second, more serious stroke in the next few weeks. 

The study recommends that people with a TIA or ischaemic stroke caused by a blood clot are treated with aspirin as soon as possible.

The reason this isn't recommended at present is that some people will have had a haemorrhagic (bleeding) stroke, and aspirin can make the bleeding worse. 

Katharine Jenner, CEO of Blood Pressure UK says: "Until official guidelines are produced, if you have these symptoms or see someone with them, you should act F.A.S.T (see below) and call 999 for an ambulance immediately."  

Act F.A.S.T.

The main symptoms of a TIA or stroke can be remembered with the word "F.A.S.T." – Face-Arms-Speech-Time:

  • Face – the face may have dropped on one side, the person may not be able to smile, or their mouth or eye may have dropped
  • Arms – the person may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm
  • Speech – their speech may be slurred or garbled, or the person may not be able to talk at all, despite appearing to be awake
  • Time – it is time to dial 999 immediately if you see any of these signs or symptoms

Rothwell PM, Algra A, Chen Z, et al. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. The Lancet. Published online May 18 2016