Here’s a great article on transient ischemic attacks (TIAs), strokes, and aspirin (ASA) use:
🔗 Oxford summary article https://www.ox.ac.uk/news/2016-05-19-immediate-aspirin-after-mini-stroke-substantially-reduces-risk-major-stroke

🔗 Original research http://doi.org/10.1016/S0140-6736(16)30511-6

As we age, we’re bound to experience more health concerns—minor annoyances, new diagnoses, and some gradual loss of function. That’s why it’s important not to dismiss symptoms just because they resolve quickly. This article highlights the critical role ASA can play in reducing the risk of major strokes after a TIA.

That said, some folks think it’s fine to skip the emergency department (ED) after a TIA—often called a “mini-stroke.”** The problem with that thinking is that a TIA is often a warning of a much larger event. Research shows the risk of a full-blown ischemic stroke spikes in the first 48 hours after a TIA and stays elevated for up to 90 days.

Why go to the ED if they “can’t fix” a TIA? Because early intervention can reduce your long-term risk. The ED team can evaluate whether a stroke actually occurred, assess your risk based on comorbidities or clotting issues, and start you on appropriate medications. They may recommend ASA or other therapies to prevent a future stroke—an event that can leave up to 50% of survivors with lasting disabilities.¹

When I had my stroke, the symptoms were mild and vague—but the risk vs. benefit of not going to the ED was what pushed me to act. They initially misdiagnosed me (cerebellar strokes are notorious for that²), but thanks to a thorough hospitalist, an MRI was ordered, neurology was called back, and they found the real cause: an open foramen ovale (OFA). It was repaired, and I was started on medications to reduce further risk.

I had no obvious long-term deficits, and because I got care, the underlying issue was addressed. That’s a win. I cannot imagine anything more devastating than suffering something preventable—simply because of the discomfort or inconvenience of a hospital visit. (That said, my care team was amazing—loved them. But still: there’s no place like home.)

🔴 PLEASE do not self-medicate. ASA can be contraindicated for people with bleeding disorders, certain diagnoses, or medication interactions. Children should not take ASA due to the risk of Reye’s syndrome. Always talk to your provider before starting ASA. If you’re already on aspirin and experiencing stomach discomfort, don’t stop it on your own—speak with your doctor. They may recommend enteric-coated aspirin (ECASA) to ease GI side effects.

⚠️ Also, try not to call TIAs “mini-strokes.” The term may seem harmless, but it can minimize the seriousness of a TIA, trivialize a stroke, and confuse the public about the difference between TIAs and full-on strokes.

References:
(1) The Stroke Foundation. (n.d.) Disability after a stroke. Retrieved 16 May 2025 from https://thestrokefoundation.org/disability-after-a-stroke/
(2) David, A.M., Jaleel, A., & Mathew, C.M.J. (2023, Feb 23). Misdiagnosis of cerebellar infarcts and its outcome. Cureus, 15(2):e35362. https://doi.org/10.7759/cureus.35362

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Editorial assistance provided by ChatGPT, a language model developed by OpenAI. Final content and perspectives are solely those of the author. Original draft version by author pre-AI available upon request. (Leave request in comments).