UC San Diego Health Sciences News

Malcolm Has a Mini Stroke: three questions for Alexander Khalessi, director of Neurovascular Surgery

Last week, former childhood star Frankie Muniz suffered a “mini stroke.” The news was remarkable for several reasons as Muniz, who was the titular star of Malcolm In the Middle, is just 27 years old and seems to live a healthy lifestyle. According to Muniz, he has “… never had a sip of alcohol in my life. I’ve never had any drugs, I’ve never even smoked a cigarette.”

According to the Centers for Disease Control, stroke is the leading cause of death in the United States, attributing to over 800,000 deaths a year. The causes for stroke range from existing conditions such as high blood pressure, to adverse behaviors such as smoking and excessive drinking. But what if you don’t have these risk factors?

We’ve asked Alexander Khalessi, MD, MS, director of Neurovascular Surgery and surgical director for the NeuroCritical Care unit at UC San Diego Health System three questions about strokes.

Question: What is a mini stroke and how does it differ from other types of stroke?

Answer: “Mini strokes” usually refer to a Transient Ischemic Attack or TIA. These events involve a temporary lack of blood flow to part of the brain. Fortunately in these cases, blood flow to the brain is spontaneously restored without permanent damage. Symptoms vary based on the part of the brain involved and may include vision loss, weakness, numbness or speech difficulty. TIA’s carry an increased risk of future stroke and often signify plaque narrowing one of the four major arteries that provide blood flow to the brain. Sudden occurrence of these symptoms requires immediate medical attention.

Q: Frankie Muniz is 27 years old and, except for suffering a stroke, in good health. Does this mean that anyone can be at risk for stroke at any time?

A: Ischemic strokes are caused by a blockage of one of the major blood vessels supplying the brain, narrowing of the arteries of the brain itself, abnormal heart rhythms, or clotting disorders of the blood. Stroke risk increases with these known conditions or comorbidities including obesity, smoking, drug use, high blood pressure or diabetes. The incidence of stroke in young people has doubled in the last decade. In a young healthy person with Mr. Muniz’s presentation, a carotid dissection or traumatic tear in the wall of the carotid artery is likely the most common cause.

Q: After suffering a stroke, what can people do to limit their chance of reoccurrence?

A: After suffering a stroke, receiving a work-up at a center that diagnoses the cause of the stroke is critical to risk assessment and secondary prevention. Were an arterial blockage responsible, the patient’s stroke risk may remain high without open surgery (carotid endarterectomy) or treatment with catheters (carotid artery stenting). For strokes due to arrhythmias of the heart, blood thinning medications and heart rate control treatments may be required. Similarly, clotting disorders of the blood may require aggressive treatment. Stroke diagnosis represents only the first step in preventing a second event.

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