A few weeks ago, I wrote about my hatred of the word "dizzy." Today, I’m going to address another term that drives me nuts: mini-stroke. Patients come to me and describe the events these ways:
• "I went to the ER. They said I had a mini-stroke."
• "Dr. Smith said my MRI showed mini-strokes."
• "I had a bunch of mini-strokes yesterday."
So what is a mini-stroke? I think a lot of people use it interchangeably with transient ischemic attack (TIA). I can’t stand that. A stroke is like being pregnant: You either are or you aren’t. In my mind, there’s no such thing as "semi-pregnant" any more than there is a mini-stroke. A TIA is not a stroke. They may be similar, but they’re NOT the same, and using mini-stroke for something that isn’t one is misleading.
Other people use the phrase to mean the nonspecific white matter changes seen on MRI, which our species collects like tree rings over time. I’m not convinced they deserve the distinction of being labeled as "strokes," either.
Another group of people may use it to mean pretty much any sort of transient neurologic phenomenon:
• "When I woke up the fingers were tingling. I shook them out, and they got better. I think it was a mini-stroke."
• "My nose was numb after I went jogging yesterday. My wife said it might a mini-stroke."
• "My doctor says all my weird thoughts might be mini-strokes, and told me to come here."
Dizzy is so entrenched in the English language that I know we’ll never be rid of it. But, this one, I can see some hope for. I’d think that education, geared to primary care doctors and the general public, would help.
But, on the other hand, it’s probably better to leave it as it is. Mini-strokes in all forms are a good source of referrals, and who wants to stop that?
Dr. Block has a solo neurology practice in Scottsdale, Ariz.