A University of Manchester study has found that almost two-thirds of patients attending what are termed ‘rapid access’ TIA clinics took more than the recommended seven days to be seen by a suitably trained professional.
A TIA, often characterised by a temporary weakening of one side of the face and the corresponding arm, drastically increases a person’s chance of suffering a major stroke within days of the initial symptoms, with some studies putting the risk as high as a one-in-four probability.
Despite the obvious importance of early assessment, the research – published today (Thursday) ahead of print in the Journal of Neurology Neurosurgery and Psychiatry – suggests that, on average, access to the specialist clinics takes at least twice as long as it should.
“Current UK guidelines recommend that all people who have had a TIA should be assessed by a specialist within seven days of the start of symptoms,” said Dr Craig Smith, from the University’s clinical neuroscience group which coordinated the research.
“Our findings suggest that this standard is not being met and, in reality, TIA patients should ideally be assessed for risk of further stroke within a couple of days, if not on the same day as the initial symptoms.”
Dr Smith and the research team studied 711 people who had sustained a TIA or minor stroke, on average, 15 days earlier and who were seen at five centres in Liverpool and Manchester in the North West of England.
A scoring system (ABCD2), which has been used to assess stroke risk very early after TIA, was also able to detect risk of stroke despite the delays in presentation to specialist assessment.
Every patient was monitored for three months to check their risk of recurrent TIA, stroke, heart attack, or death. Of the 711 patients monitored, 25 went on to have a major stroke while 100 had at least one further TIA during the follow-up period. Three people died.
“This rate of stroke was relatively low due to the delay in being able to assess the patients after their initial TIA,” said Dr Smith. “Some studies have put the number of people suffering a major stroke within a week of a TIA as high as 10%, which suggests even the seven-day guideline figure may be inadequate.”
The delay in TIA patients being assessed by a stroke specialist is due to a number of reasons, including the patients themselves not realising the potential serious nature of the attack. Initial symptoms are temporary, lasting a matter of minutes or hours before the face, arm and, sometimes, leg return to normal, so patients often feel well by the time they are seen by a clinician.
Dr Smith added: ”Our findings suggest that current provision of TIA services, where delayed presentation to ‘rapid access’ TIA clinics is common, does not appear to provide an appropriate setting for urgent evaluation or timely secondary prevention in those who may be at the highest risk of stroke.
“If the speed with which TIA patients can be evaluated is improved many strokes in the UK each year could be prevented.”
Aeron Haworth | alfa
Amputees can learn to control a robotic arm with their minds
28.11.2017 | University of Chicago Medical Center
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.
To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...
The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.
Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...
With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong
Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...
An interdisciplinary group of researchers interfaced individual bacteria with a computer to build a hybrid bio-digital circuit - Study published in Nature Communications
Scientists at the Institute of Science and Technology Austria (IST Austria) have managed to control the behavior of individual bacteria by connecting them to a...
Physicists in the Laboratory for Attosecond Physics (run jointly by LMU Munich and the Max Planck Institute for Quantum Optics) have developed an attosecond electron microscope that allows them to visualize the dispersion of light in time and space, and observe the motions of electrons in atoms.
The most basic of all physical interactions in nature is that between light and matter. This interaction takes place in attosecond times (i.e. billionths of a...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
11.12.2017 | Physics and Astronomy
11.12.2017 | Earth Sciences
11.12.2017 | Information Technology