What Is It?
A transient ischemic attack (TIA) is an episode of stroke-like symptoms. It usually lasts less than one hour. A TIA is sometimes called a ministroke.
During a TIA, circulation to a part of the brain is interrupted briefly, then restored. This interruption can be caused by:
A narrowing of a brain artery because of atherosclerosis.
A small floating blood clot. This clot enters the bloodstream from somewhere else in the body, often the heart. It temporarily blocks a brain artery.
Symptoms
Symptoms of a TIA are the same as those of stroke. However, TIA symptoms usually last for less than one to two hours. Most TIAs actually last only five to 20 minutes.
Symptoms of a TIA can include:
Dizziness or confusion
Weakness or paralysis on one side of the body
Sudden, severe numbness in any part of the body
Visual disturbance, including sudden loss of vision
Difficulty walking, including staggering or veering
Coordination problems in the arms and hands
Slurred speech or inability to speak
Diagnosis
Your doctor will ask about:
Your current symptoms
Your medical history, including conditions that increase your risk of stroke, such as:
Smoking
Certain types of heart disease
Your doctor will examine you. He or she may pay special attention to the circulation in your neck. This is where major arteries supplying the brain are located. While examining your neck, the doctor will listen with a stethoscope for turbulent sounds. These sounds indicate that blood is flowing through narrowed arteries.
Blood tests will be done. Your doctor will also do a test called an electrocardiogram (EKG). An EKG measures the electrical activity of your heart.
Your doctor may order a computed tomography (CT) or magnetic resonance imaging (MRI) scan of your brain. These will help to help pinpoint the cause of a TIA.
To evaluate flow through blood vessels, your doctor may do other tests. These include Doppler ultrasound, magnetic resonance angiography (MRA) or X-ray angiography.
If your doctor suspects that floating blood clots are coming from your heart, special heart tests may be necessary.
Expected Duration
The onset of any symptoms suggestive of a stroke or TIA requires immediate medical attention.
You can expect a TIA to last less than one to two hours. If symptoms are not improving quickly within one hour from onset, a stroke is likely to occur without emergent therapy.
Prevention
You can help to prevent TIAs by:
Not smoking
Keeping blood pressure within the normal range
You may need medications to bring down your blood pressure.
Lowering your LDL cholesterol level
For high LDL cholesterol that doesn't respond to diet, statin drugs offer the most protection against TIA and stroke.
Taking a low dose of aspirin if your doctor determines the benefits outweigh the risks for you
Exercising regularly
Eating a healthy diet that is:
Rich in fruits and vegetables
Low in saturated fats and cholesterol
Treatment
When treating TIAs, the ultimate goal is to prevent a full-fledged stroke.
Most TIAs are treated with antiplatelet medications. The choices include:
Aspirin only
Aspirin combined with dipyridamole (Aggrenox)
Clopidogrel (Plavix)
If you have significant narrowing of part of the carotid artery in the neck, surgery may be done to correct the problem. This will help prevent future TIAs and stroke. The procedure is called carotid endarterectomy or carotid artery stenting.
Some TIAs are related to small free floating blood clots in the heart. These clots can occur in people with atrial fibrillation or advanced heart failure. In this situation, your doctor may choose anticoagulation (anti-clotting) medications such as heparin and warfarin.
When to Call a Professional
Call your doctor immediately whenever anyone has symptoms of stroke. Call even if these symptoms last only a few minutes. TIAs can be a warning sign that a stroke is about to happen. They require prompt attention.
Prognosis
Without treatment, having a history of one or more TIAs significantly increases your risk of stroke compared with someone who has never had a TIA.
Additional Info
National Stroke Association
9707 E Easter Lane
Building B
Centennial, CO 80112
Toll-Free: 800-787-6537
Fax: 303-649-1328
http://www.stroke.org/
National Institute of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824
Phone: 301-496-5751
Toll-Free: 1-800-352-9424
TTY: 301-468-5981
http://www.ninds.nih.gov/
