'Mini-stroke' may lead to post-traumatic stress disorder

Transient ischemic attack (TIA), like stroke, is caused by restricted blood supply to the brain. A TIA is temporary and often lasts less than five minutes, without causing permanent brain damage.

"We found one in three TIA patients develop PTSD," said Kathrin Utz, Ph.D., a study author and post-doctoral researcher in the Department of Neurology at the University of Erlangen-Nuremberg in Germany.

"PTSD, which is perhaps better known as a problem found in survivors of war zones and natural disasters, can develop when a person experiences a frightening event that poses a serious threat."

The study is the first to analyze whether a TIA and the knowledge of an increased risk for stroke can lead patients to develop psychiatric problems.

After examining data from 108 TIA patients with no prior history of stroke and reviewing participants' answers to a series of questionnaires that evaluated their mental state, German and British researchers found:

• About 30 percent of patients with TIA disclosed symptoms of PTSD.
• About 14 percent of all TIA patients showed significantly reduced mental quality of life and 6.5 percent had reduced physical quality of life.
• Those with PTSD showed higher signs of depression, anxiety and reduced quality of life.

Patients' fear of having a stroke and poor coping behaviors after a TIA may be partially to blame for them developing PTSD.

"While their fear is partly justified, many patients may be overestimating their risk and increasing their chances of developing PTSD," Utz said.

"When experienced together, the symptoms from TIA and depression pose a significant psychological burden on the affected patient; therefore, it comes as no surprise that we also found TIA patients with PTSD have a measurably lower sense of quality of life."

Even a brief neurological disorder, which in itself doesn't lead to a chronic disability, can be just as traumatic as an event like a traffic accident or natural disaster, researchers said. The way a patient normally responds to stressful situations may help determine their risk of developing PTSD after a TIA.

"Patients who use certain types of coping strategies, such as denying the problem, blaming themselves for any difficulties or turning to drugs for comfort, face a greater risk of developing PTSD after TIA," Utz said.

"It is not yet entirely clear why some people develop PTSD following a TIA, but others do not. However, what we do know at this stage is that younger patients and patients who in general find it difficult to cope with stress are more likely to develop psychological problems following a TIA."

Utz suggests providing patients better risk counselling and more positive adaptive strategies to cope with TIA.