Fatigue may linger for a year after a mini-stroke, especially in people with prior anxiety or depression. Even when physical symptoms vanish in a day, tiredness can stubbornly remain.
A transient ischemic attack, or TIA—often called a mini-stroke—is typically seen as a brief blockage of blood flow to the brain. The symptoms, like slurred speech or arm weakness, usually disappear within a day. But new research suggests the impact may last far longer than expected.
A study published on May 14, 2025, in Neurology, the journal of the American Academy of Neurology, found that many people who experience a TIA report lingering fatigue that can continue for up to a year. While the study doesn’t prove that the mini-stroke directly causes the fatigue, it reveals a strong link between the two.
More Than Just a One-Day Event
“People with a transient ischemic attack can have symptoms such as face drooping, arm weakness, or slurred speech, and these resolve within a day,” said study author Boris Modrau, MD, PhD, of Aalborg University Hospital in Denmark. “However, some have reported continued challenges including reduced quality of life, thinking problems, depression, anxiety, and fatigue. Our study found that for some people, fatigue was a common symptom that lasted up to one year after the transient ischemic attack.”
Researchers followed 354 individuals, with an average age of 70, who had experienced a mini-stroke. Each participant was tracked for a full year to monitor their recovery.
To measure their fatigue levels, participants filled out detailed questionnaires within two weeks of their stroke and again at three, six, and twelve months.
Five Faces of Fatigue
One questionnaire looked at five different types of fatigue, including overall tiredness, physical tiredness, reduced activity, reduced motivation, and mental fatigue. Scores ranged from four to 20, with higher scores indicating more fatigue. Participants had an average score of 12.3 at the start of the study. At three months, the average score decreased slightly to 11.9, at six months to 11.4, and at twelve months to 11.1.
Researchers looked at how many participants experienced fatigue, as defined as a score of 12 or higher. Of the participants, 61% experienced fatigue two weeks after the mini-stroke, and 54% experienced fatigue at each of the three other testing time periods at three, six, and 12 months.
Brain Scans Don’t Explain It
Participants also had brain scans. Researchers found that the presence of a blot clot on a scan was equal between people with long-term fatigue and those without it, so this did not explain the reason for the level of fatigue.
Researchers did find that previous anxiety or depression was twice as common in those participants who reported lasting fatigue.
Why Ongoing Monitoring Matters
“Long-term fatigue was common in our group of study participants, and we found that if people experience fatigue within two weeks after leaving the hospital, it is likely they will continue to have fatigue for up to a year,” said Modrau. “For future studies, people diagnosed with a transient ischemic attack should be followed in the weeks and months that follow to be assessed for lingering fatigue. This could help us better understand who might struggle with fatigue long-term and require further care.”
A limitation of the study was that while participants were asked to complete the questionnaires themselves, it is possible some responses may have been completed with assistance from relatives or caretakers, and this may have influenced responses, including those around fatigue.
Reference: “Long-Term Fatigue Following Transient Ischemic AttackA Prospective Cohort Study” by Birgitte Hede Ebbesen, Simon Grøntved, Jakob Nebeling Hedegaard, Søren P. Johnsen, Jane Andreasen, Krystian Figlewski, Mirko Porobic, Michael Skovdal Rathleff and Boris Modrau, 14 May 2025, Neurology.
DOI: 10.1212/WNL.0000000000213605
The study was supported by the Danish Physiotherapy Association.
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2 Comments
This is quite insightful. It’s intriguing, part of what I see unfolding as a new paradigm in medical science, where the patients’ mindset and outlook on life intimately affect their organic health. A positive outlook and clear, hopeful purpose gives people a much better shot at life, both psychologically and physically. We’ll undoubtedly be seeing more such developments in different branches of the healing arts.
TIA’s were dismissed by doctors for years in my area until my mom died. Coroner put it sqarely at the feet of incompetent diagnoses. Get it together, docs!