Are complications after minor stroke associated with disability?

This study investigated factors associated with disability after a minor stroke. Researchers suggested that complications after a first minor stroke are strongly associated with disability or even a second stroke.

A stroke happens when blood flow to the brain is cut-off by a blood clot. As oxygen does not reach brain cells, they begin to die. The abilities controlled by these cells are lost causing symptoms such as arm disability. When the blood supply is cut-off for a very short period of time, it is called minor stroke or a transient ischemic attack (TIA). 

Patients with a minor stroke or a TIA are often not eligible for treatment with tissue plasminogen activator (tPA). tPA is responsible for the breakdown of blood clots. This decreases the risk of after-stroke complications or even of a second stroke. Prior studies showed that this only works with disabilities caused by the stroke.

Several studies showed that up to one-third of these patients are disabled after the stroke. Therefore, tPA should be used to treat these patients. It remains unclear how many reported disabilities are actually due to complications associated with stroke or other pre-existing disabilities.

This study included information about 3663 patients with minor stroke and 2384 with a TIA. Off these, 687 (19%) patients with stroke and 122 (5%) with TIA were disabled at 90 days after the event. Disability was defined by a modified Rankin Scale [mRS] score higher than 1. Factors associated with disability were examined and compared between groups.

Age and diabetes were associated with disability in the stroke group. Disability was strongly associated with a second stroke, heart attack, and major bleeding. 39% of the patients with a stroke who had disability ended up having an event. In the TIA group, 65% of the patients with disability ended up having an event. Disability was greater in those with arm weakness. 

This study concluded that complications after a minor stroke or TIA are strongly associated with disability.