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Suffer stroke symptoms? Second strokes often follow within hours

About half of all people who have a major stroke following a warning stroke (a transient ischemic attack or mild stroke) have it within 24 hours of the first event, according to research published in the June 2, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology.

"Our study highlights the need for someone who is experiencing the symptoms of a mini-stroke or transient ischemic attack to get to an emergency room fast," said Peter Rothwell, MD, PhD, FRCP, FMedSci, with the University of Oxford in the United Kingdom. "That's because even after a very minor initial stroke, the immediate risk of a major stroke is very high."

For the study, researchers analyzed the medical records of 1,247 people who experienced a TIA, or minor stroke. Of those, 35 had recurrent strokes within 24 hours during the first month after experiencing the TIA.

Scientists looked at whether patients had another stroke within six, 12 and 24 hours after the first stroke. The timeline started when the person either experienced symptoms of a stroke or first called for medical help. The study found that after six hours, the risk of a second stroke went up by 1.2 percent. After 12 hours, the risk climbed another percent and by 24 hours the risk increased to 5 percent.

"This is the first rigorous population based study of the risk of a second stroke within 24 hours of a minor stroke," said Rothwell. "We found a second stroke rate of about 5 percent, with half of all second strokes within seven days occurring in the first 24 hours, and half of these early recurrent strokes being disabling or fatal."

To learn the five signs of stroke, visit Give Me Five for Stroke is a joint campaign of the American Academy of Neurology, the American College of Emergency Physicians and the American Heart Association/American Stroke Association to encourage people to recognize stroke symptoms, call 9-1-1, and get to the emergency department.

The study was supported by the UK Medical Research Council, the National Institute of Health Research, the Stroke Association, the Dunhill Medical Trust and the Oxford Partnership Comprehensive Biomedical Research Center.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke.

For more information about the American Academy of Neurology, visit or

Rachel Seroka | EurekAlert!
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