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Friday, 22 March, 2002, 15:56 GMT
Minor strokes
Baroness Thatcher has been told to give up public speaking after suffering a number of minor strokes over recent months.

BBC News Online looks at the medical condition.

Minor strokes can cause temporary weakness or numbness in an arm or leg, but the effects may only be short-lived.

Doctors say that if you have one minor stroke, there is a 40% chance that you will have another within five years.

Having a series of strokes is relatively uncommon.

However, a minor stroke - at its least severe called transient ischaemic attack (TIA) - can also be a warning sign before a more serious stroke.

The effects of a smaller stroke can range from the minor - some numbness or tingling - to the severe - where the patient may suffer slurring or loss of speech, difficulty swallowing, the mouth may droop, and there may be dribbling, headache, dizziness and confusion.

In Baroness Thatcher's case, it is said that she suffered no paralysis or loss of speech after any of her minor strokes.

A stroke occurs when part of the brain is suddenly deprived of oxygen-rich blood, and can be caused by a blood clot forming in a damaged vessel or a damaged vessel in the brain bursting.

'Worse off'

A full stroke causes the death of brain tissue, and can cause lasting disability.

Red blood cells
A blocked blood vessel is the most likely cause of stroke
A TIA is defined as an event which lasts less than 24 hours and leaves no disability, but even these may cause permanent damage to tiny regions of the brain, revealed only on a brain scan.

Professor Philip Bath, the Stroke Association professor of stroke medicine at the University of Nottingham, told BBC News Online: "Talking in general terms - every time you have a minor stroke, you chip away - you have done a bit more damage.

"People who have recurrent stroke are more likely to end up in a worse situation."

People who have more than one stroke should be investigated thoroughly by doctors to find out the cause, he said.

As well as being at greater risk of another stroke, there is also an increased risk of heart attack.

The good news is that recurrent strokes are preventable

Professor Philip Bath, University of Nottingham
Patients may be given a cocktail of drugs to help lower the risk of a recurrence.

This includes blood-thinning drugs similar to aspirin, diuretics, blood pressure medication and even drugs to reduce cholesterol levels in the blood stream.

Professor Bath said: "The good news is that recurrent strokes are preventable - although there will always be people who have another, whatever you do.

"But any TIA or minor stroke should be looked into, and a number of investigations carried out on the patient."

There are fears that some doctors are failing to notice TIAs or "mini-strokes" - and that almost one in ten people aged 65 or over have suffered from them, as opposed to the 1% previously thought.

Damage caused

A spokesman for the Stroke Association said that a "mini-stroke" should never be ignored, as about one in four who have one will go on to have a full stroke within a few years.

A spokesman said: "Symptoms should receive urgent medical attention, even if they last for only a few hours."

Approximately 140,000 people have a stroke every year - 30,000 of these will be a recurrence.

The effects of a stroke or TIA depend entirely on where in the brain it has occurred.

The Stroke Association spokesman said: "For some people, their face will be paralysed, in others their speech will slur - again, it depends on where it happens and it's down to the doctor's clinical judgement to decide where the stroke occurred."

See also:

22 Mar 02 | UK Politics
Thatcher told to quit public speaking
22 Mar 02 | UK Politics
Margaret Thatcher: Tory titan
22 Mar 02 | UK Politics
In pictures: Years of power
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