Victims of mild strokes need more attention

New guidelines for follow-up to mild strokes may be needed, according to data presented by researchers at the Canadian Stroke Congress in Ottawa. Their point, importantly, was that many patients who suffer a mild stroke without major impairments of speech or mobility do not receive adequate management and treatment afterward.

After interviewing 200 mild stroke victims (age 62, on average) within six weeks of their first stroke, researchers discovered that nearly a quarter of these patients were clinically depressed. Although they had not suffered the speech or motor impairments that would result from a more severe stroke, these stroke victims experienced fatigue, loss of appetite, lack of concentration, disturbed sleep, and thoughts of suicide. The authors also noted that nearly a quarter of such patients are treated in an emergency room only and are never seen by occupational therapists, neuropsychologists, or speech therapists. But given that people who have suffered a mild stroke are five times more likely to have another stroke within the next two years, say the authors, these patients would benefit from a management and treatment plan that monitors them intensively and addresses their current concerns and risk factors for vascular disease.

A patient who has experienced a stroke of any severity needs to be monitored, says ACSH's Dr. Gilbert Ross. Simple adjustments can be made, such as increasing blood pressure medication, having patients take a daily aspirin, and persuading them to stop smoking. He notes that, given the frequency of cerebrovascular disease and the large toll of stroke-related death and disability, the researchers recommendations should be taken seriously.