THREAD: A significant number of people could at risk of having a major stroke, if they continue to stay away from the NHS during the Covid-19 outbreak.

Despite indications that people are now returning to A&E in normal numbers seeking help with some other conditions, Exeter consultant stroke physician Prof. Martin James says there are still worries about people not presenting with stroke symptoms.

While stroke doctors noted drops in attendance of 30 – 50 % in March and early April, this now stands at about 10%, he says.

But of more concern is those failing to seek medical help after experiencing a TIA (transient ischaemic attack) – often called a ‘mini-stroke’.

“Our clinic in Exeter is down 20 – 30%” he says, a pattern reported elsewhere in the country. The fear is that by failing to seek help after a mini-stroke, doctors won’t be able to prevent a future major stroke.

“Currently around one in five people suffering a full stroke will have had a mini-stroke in the recent past,” Prof. James explains. One in 20 people will have a major stroke within two days of a mini-stroke and this figure rises to one in 12 within a week.

“Our worries are 1) people are struggling alone with the disabling effects of a stroke, without help or rehabilitation and 2) that for those not presenting to the NHS after a mini stroke, the next time we see them will be when they experience a big stroke.”

Currently, around 50,000 people a year experience a TIA in the UK.