Hailey Bieber, model, entrepreneur and wife of famous Canadian Justin Bieber, suffered a mini-stroke or transient ischemic attack (TIA) earlier this year.
The stroke was a surprise for the 25-year-old.
How did it happen? Should other young people be worried?
This is an age group is not typically associated with stroke, but doctors say it’s important to be aware that stroke affects people of all ages.
Dr. Mark Boulos, a Sunnybrook neurologist and stroke expert, answered our questions about TIAs, Hailey’s unexpected health event, and tips for stroke prevention.
Note: Dr. Boulos is not Hailey Bieber’s doctor. His responses are based on the comments she shared in her YouTube video about her TIA.
What is a stroke and how does it compare to a mini-stroke or TIA?
A stroke is when blood flow to the brain gets interrupted, leading to damage to the brain. This can be caused by blocked blood vessels or hemorrhaging.
A “mini-stroke” or a TIA happens when you have transient deficits due to lack of blood flow to a specific part of the brain, but when you do scans, you don’t see any damage. And while they may not leave a mark on the brain, TIAs are still important to pay attention to as they can be warning signs for future stroke.
We don’t typically associate TIAs or strokes with young people. How did this happen in Hailey Bieber’s case?
In her YouTube video, Hailey mentioned that she did have some risk factors, which wouldn’t typically be problematic on their own. But together, it looks like they created the perfect storm.
She mentioned that she was on birth control, and some forms of birth control in young women increases the risk of stroke a little bit. Not very much, but that would have been a risk factor for her. She also noted that she suffers from migraines, and the combination of using some forms of birth control and having migraines can further increase the risk of stroke.
She also recently had COVID, which can also increase your chance of blood clots.
She mentioned she had been on a plane, too. If you’re on a plane and you’re sitting in the same spot for a long time, clots can develop in your legs then travel through your body, including to your brain via something in the heart called a Patent Foramen Ovale, or PFO, which she mentioned she had in her YouTube video. That would have been a trigger as well.
To elaborate on PFOs, there is this connection between the two sides of the heart, which is supposed to naturally close when you are a fetus. In 25 per cent of the population it doesn’t close, leaving a hole in the heart, or a PFO. This isn’t typically a problem, but it can become a problem.
Clots are usually kept on the right side of the heart, which controls the circulation to the lungs. If the clot stays in there, it’s actually OK. The trouble is that a PFO could facilitate a clot going from the right side of the heart to the left. The left side of the heart pumps blood to the rest of the body, including to the brain. If a clot gets into the left side of the heart and goes up to the brain, that could lead to a stroke.
The combination of all these factors could have led to Hailey’s TIA.
These risk factors are all so common. Should young people who have these risk factors be worried about TIAs or strokes?
Statistically, TIAs and strokes are not common in young people. They do happen, but if you’re young and healthy, the risk is minimized. It is important, however, to be aware that stroke can strike at any age.
In general, while the factors mentioned are common, more context is needed around the risk of stroke.
If you’re on some forms of birth control, this can increase your risk of having a stroke, but the risk is minimal. About eight in 100,000 women who are on birth control will have a complication like a stroke. The risk of stroke in women who use some forms of oral birth control is further increased in those with migraines. If you’re worried, have a discussion with your doctor.
If you’re going to be in a plane for a long time, stroke risk prevention is very simple. Walk around, stay hydrated, move your legs to help prevent clots from developing. Just don’t sit in the same spot for a long time.
PFOs are present in about 25 per cent of people, but that doesn’t mean 25 per cent of people will have a stroke. In fact, many people with PFOs never even realize they have them.
It’s important to speak with a health-care professional if there are concerns about risk factors for stroke.
How can people reduce their risk of stroke?
There are things that always help prevent overall vascular risk factors: exercise, healthy eating, not smoking, keeping your cholesterol in check, monitoring your blood pressure, getting enough sleep every night and checking for sleep apnea. To avoid stroke, these things are important for everyone, including young people.
And of course, knowing the warning signs of stroke to get help right away is important. The earlier a person is treated, the greater their chances of recovery. Knowing the warning signs can help you act fast to get the help needed, if you or someone you know is experiencing a stroke.