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Major Stroke Risk Substantial After Minor Event: Study
Date:11/12/2007

when interpreting its results," they concluded.

The researchers said reliable estimates of major stroke risk following a TIA could maximize the benefits of early treatment, allow effective planning of service for patients, assist in the design of clinical trials, and justify investment in public education.

Another expert, Dr. Keith Siller, medical director of New York University Medical Center's Comprehensive Stroke Care Center, called the study important for several reasons.

"The significant recurrence rate of a second more serious stroke within only one week's time shows that a patient with a minor stroke or TIA is not 'out of the woods' just yet and still remains at risk for an even worse stroke that mandates urgent hospitalization to expedite their evaluation even though they may appear to be back to normal," Siller said. "This is analogous to a patient with chest pain who may be having angina as a warning for impending heart attack and is admitted for additional testing to avoid sending them home and having them suffer a fatal heart attack outside the hospital."

Siller, who's also an assistant professor at the NYU School of Medicine, added that the study also emphasizes that "patients with TIA or minor stroke should be treated in stroke centers with specialized units since the care provided is specifically targeted for stroke and does result in better outcomes compared to a general medical ward."

What's more, Siller said, "these results need to be understood by insurance companies and HMOs that have unofficially discouraged doctors from admitting these same patients and prefer them to be worked up electively as outpatients. The reality is that completing all of the necessary testing as an outpatient within one week is often not possible, during which time the patient may have the second more devastating stroke that might have been prevented had they been in the hospital setting."

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