Should my mother see a stroke specialist for memory loss due to a mini stroke?

A fellow caregiver asked...

My mother had a mini stroke and it's affected her short term memory and ability to use the right words. She wasn't hospitalized and her doctor felt that she would recover within a few days. It's been 2 weeks and she has good and bad days and her speech and memory are still affected. She's going to a speech therapist next week, but what else can be done for her? Should she go to a stroke specialist?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

As a stroke specialist myself, I have a bias that there is no substitute for seeing a stroke specialist to help determine the cause of a stroke, and how best to prevent another stroke.

I've never been a big fan of the term "mini-stroke" - I think it minimizes the event.  Patients either have a TIA (in which the symptoms should COMPLETELY resolve within one day), or they have a "stroke".  There is nothing "mini" about a stroke that leaves someone unable to speak or remember properly.  Given the fact your mother still has symptoms, she had a true "stroke".  Since her stroke affected her memory, it may have involved a part of the brain supplied by arteries known as the "posterior circulation".  These arteries are often not fully evaluated by standard stroke testing, but could be fully evaluated by a stroke specialist.  Given the chance for recurrence, I think it is worth looking into.  Even strokes in the "anterior circulation" may not have been fully evaluated by standard testing.

Finally, a stroke specialist may have good ideas for a recovery strategy, sometimes including the use of therapists, for helping your mother improve her speech and memory.  In most parts of the country, there is a stroke specialist within a few hours drive, and I certainly think it is worth the trip.