Fatigue can persist for up to a year following a mini-stroke, particularly among individuals with a history of anxiety or depression. While physical symptoms often resolve within a day, the fatigue associated with a transient ischemic attack (TIA) can be stubborn and long-lasting. New research highlights the significant impact of TIAs, suggesting that the effects may extend far beyond the initial incident.
A transient ischemic attack, commonly known as a mini-stroke, involves a temporary blockage of blood flow to the brain. Symptoms such as slurred speech, arm weakness, and face drooping typically resolve within 24 hours. However, recent findings published on May 14, 2025, in the journal Neurology by the American Academy of Neurology indicate that the aftermath of a TIA can lead to ongoing challenges, particularly fatigue, which can linger for up to a year.
The study, led by Dr. Boris Modrau from Aalborg University Hospital in Denmark, tracked 354 individuals with an average age of 70 who had experienced a mini-stroke. Researchers observed these participants for a year, assessing their recovery and fatigue levels through detailed questionnaires at two weeks, three months, six months, and twelve months post-stroke.
“Although the immediate symptoms of a transient ischemic attack resolve quickly, some individuals report ongoing issues such as reduced quality of life, cognitive difficulties, depression, anxiety, and persistent fatigue,” explained Dr. Modrau. The study revealed that fatigue was a common symptom lasting up to one year after the TIA.
To evaluate fatigue levels, participants completed a questionnaire assessing five types of fatigue: overall tiredness, physical tiredness, reduced activity, reduced motivation, and mental fatigue. Scores ranged from four to 20, with higher scores indicating greater fatigue. Initially, participants had an average score of 12.3, which showed a slight decrease over the year, landing at 11.1 by the twelve-month mark. Notably, 61% of participants reported fatigue just two weeks after the TIA, with 54% continuing to experience fatigue across all subsequent assessments.
Participants also underwent brain scans to investigate potential underlying causes of long-term fatigue. Interestingly, the presence of a blood clot on the scans was similar between those who reported persistent fatigue and those who did not, indicating that brain imaging may not provide insights into the fatigue experienced post-TIA. However, the study found a notable correlation between previous anxiety or depression and the likelihood of enduring fatigue, with these conditions being twice as prevalent among participants reporting long-term fatigue.
Dr. Modrau emphasized the necessity of monitoring individuals following a transient ischemic attack. “Our findings suggest that if fatigue is reported within two weeks after a TIA, there’s a significant chance it will persist for a year,” he stated. Long-term follow-up studies could help identify patients at risk for enduring fatigue, allowing for tailored care and support.
One limitation of the study was the self-reported nature of the questionnaires, as some responses may have been influenced by relatives or caretakers, potentially skewing fatigue assessments.
The research titled “Long-Term Fatigue Following Transient Ischemic Attack: A Prospective Cohort Study,” authored by Birgitte Hede Ebbesen and colleagues, underscores the need for increased awareness of the long-term effects of TIAs. As ongoing fatigue can significantly impact an individual's quality of life, understanding and addressing these symptoms is crucial for improving recovery outcomes.
The study was supported by the Danish Physiotherapy Association and emphasizes the importance of further investigations into the long-term effects of transient ischemic attacks on fatigue and mental health.
