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A Mini-Stroke Called A TIA Can Spark Post-Traumatic Stress

People who have had a very mild form of stroke called a transient ischemic attack, or TIA, are at risk of post-traumatic stress disorder, with almost one-third of people later diagnosed with PTSD, a study finds.

Earlier studies have shown that PTSD is more common in people who have had a full-blown stroke. Stroke patients also are more likely to be depressed and have lower quality of life.

This appears to be the first study to look exclusively at PTSD in people with TIAs, which typically last just a few minutes and don't have lasting symptoms.

The study followed 108 people in Germany who had had a TIA. Three months later, 32 of them met the criteria for a diagnosis of PTSD, including re-experiencing the event. That rate is 10 times as high as in the general population. The people with PTSD were also more likely to have symptoms of anxiety and depression. The study was published Thursday in the journal Stroke.

Twenty-nine percent seems pretty high, says Dr. Larry Goldstein, a professor of neurology at Duke University Medical Center who was not involved in the study. "The overall average is 13 percent" for TIAs and strokes combined, Goldstein told Shots.

Studies on this vary a lot in how symptoms are measured, Goldstein notes. And doctors aren't always attuned to the fact that PTSD can be an issue after a TIA.

"Patients are very frequently quite anxious after a TIA," he says. "We're relatively well-attuned to managing anxiety, but I don't know how well-attuned we are to PTSD."

The anxiety is understandable, since about one-third of people who have a TIA will eventually go on to have a stroke, according to the National Institutes of Health. People who have been diagnosed with a TIA are often put on blood-thinning medication to reduce risk.

But a TIA diagnosis isn't always a sure thing, Goldstein says, and people may be getting worried about something that never actually happened to them. "If people have a spell and doctors can't figure out a cause, it's labeled as a TIA," he says. "It certainly happens not infrequently."

The best response is not to worry, but to take steps to reduce the risk of stroke, Goldstein says. That includes identifying risk factors and acting to reduce them by quitting smoking, exercising, eating right and getting blood pressure under control, according to the NIH.

The fact that patients who have had TIAs can develop PTSD suggests that it's not brain damage or disability typical of a stroke that's causing the problem, the study authors write. People who have trouble coping after a TIA deserve more help, they say.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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