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Standard Tests Could Miss Cognitive Damage In Ministroke Patients
The findings, reported by Canadian researchers February 24 at the International Stroke Conference in San Antonio, Texas, suggest that after suffering the ministrokes many patients lose some ability to process abstract thoughts, reason things out and make quick calculations — what doctors call “executive function.”
While full-blown strokes cause a clear loss of cognitive function, most often due to a blood vessel blockage in the brain that shows up on an MRI or CT scan, ministrokes are caused by smaller obstructions. They result in more subtle deficits that are less likely to be detected by brain scans or even by patients themselves. Some scientists consider the term ministroke a misnomer, preferring the technical term transient ischemic attack, while others use the terms interchangeably.
The symptoms of a ministroke or a full-blown one might start out the same, with numbness in the face or extremities, confusion, vision problems, dizziness or headache. But in a ministroke, these symptoms wane after minutes or hours.
In the new study, researchers tested 140 such patients in whom symptoms subsided within 24 hours, indicating they had ministrokes instead of full-blown ones. They gave the subjects a test of cognitive acuity that is routinely given to patients who show up at a clinic or hospital with signs of a stroke. Known as the Mini-Mental Status Exam, the test quickly gauges 30 cognitive functions including short-term recall, attention span, spatial recognition and executive function.
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