Identifying Mini Stroke Warning Signs: Key Risk Factors and Who Should Be Vigilant

Experiencing facial droop, arm weakness, and speech difficulties could signal an oncoming stroke, with these symptoms often associated with mini strokes.

Each year, around 46,000 people in the UK encounter a mini stroke, known medically as a transient ischaemic attack (TIA), for the first time. Despite this, awareness of the telltale signs and high-risk groups remains low.

Many individuals dismiss these episodes as minor or inconsequential because the symptoms—such as vision disturbances, vertigo, nausea, dizziness, balance issues, swallowing difficulties, and confusion—tend to resolve within minutes.

Nevertheless, a mini stroke is a critical medical condition that demands immediate attention if suspected.

TIAs happen when the brain is briefly deprived of oxygen due to an interruption or blockage in blood flow, leading to symptoms similar to those of a major stroke.

Dr Tom French, a stroke consultant at NHS Forth Valley, describes mini strokes as ‘a heart attack of the brain’.

Speaking to The Telegraph about the differences between the attacks and a full-blown stroke, he added: ‘In the UK, we tend to say, if your symptoms have gone within 24 hours, then it’s a TIA.’

Although strokes and TIAs share many of the same symptoms, strokes can last for more than 24 hours. 

Around 46,000 Britons experience a mini stroke – known as a TIA – for the first time each year

Many health organisations promote the acronym ‘BE FAST’ as a simple way to recognise the warning signs of stroke and how they manifest in different parts of the body. 

It stands for balance, eyes, face, arms, and speech, with T representing ‘time to act fast’. 

Despite this, Dr French explained that it can be difficult to pinpoint the exact signs of a TIA, as symptoms often overlap with other conditions. 

For example, older people with facial drooping may sometimes be diagnosed with a mini stroke, when the real cause is low blood pressure linked to postural hypotension – a condition that can trigger dizziness, blurred vision and weakness. 

While many people who experience TIAs are aged 50 or older, Dr French said he has treated patients as young as their 20s who initially believed they were suffering from a migraine. 

Previous studies have found that up to one in five suspected TIA patients do have migraines with aura, intense headaches which cause people to see flashing lights and feel sensations travelling down their arms or legs.

But, Dr French warned: ‘If you think you’re having a stroke, you must get immediate medical attention. ‘These are clinical diagnoses so don’t just assume it’s a migraine.’

He added that younger people may be at greater risk if they are born with a hole in the heart, known medically as a patent foramen ovale.

While all unborn foetuses have this opening, it usually closes before birth. However, the NHS says it remains open in up to one in four people. 

This can increase the risk of blood clots forming and travelling to the brain, potentially triggering a TIA.

Among older people, Dr French also warned that atrial fibrillation – a condition where the heart beats irregularly – is one of the biggest causes of a mini stroke.

He said this is because the top of the heart is ‘essentially not beating and squeezing properly,’ causing a pool of blood to form near your heart which can turn into a blood clot before travelling to the brain and triggering a TIA.

The NHS say it is ‘important to be assessed by a healthcare professional as soon as possible if you think you’ve had a TIA.’

Once patients have been initially assessed, they are typically given aspirin – which makes the blood less sticky and prevents further blood clots from forming – and are referred to a specialist within 24 hours of their first symptoms.

Because TIAs often pass within minutes, many patients no longer have symptoms by the time they are seen by a doctor.

However, Dr French says he looks for patterns in how the brain has been affected when assessing a patient. 

For example, a TIA on the left side of the brain is more likely to cause speech problems.

The doctor emphasised that many TIAs are driven by lifestyle choices made in early adulthood, with the consequences often emerging later in life. 

He said: ‘It’s a build-up of choices that people have made in their 20s, 30s and 40s. That gives them these problems in their 50s, 60s and 70s. High cholesterol and high blood pressure are the risk factors for a TIA and people choosing to live off microwave meals with a lot of salt in them will drive blood pressure. 

‘Processed foods will also play a big part in this over the next 20 to 30 years.’ 

The NHS say the best way to reduce the risk of a TIA is to maintain a healthy diet, exercise regularly, avoid smoking and limit alcohol intake. 

They add: ‘These lifestyle changes can reduce your risk of problems such as your arteries becoming clogged by fatty substances called atherosclerosis, high blood pressure and high cholesterol, all of which can lead to TIAs.

‘If you’ve already had a TIA, making these changes can help reduce your risk of having a full stroke or another TIA in the future’.