Kevin Lutz, MD, FACP
May 1 2018

When blood flow to part of the brain stops for a short period of time it is called a transient ischemic attack, abbreviated as a TIA. Some people may call it a “mini-stroke” because in many ways it appears to be a stroke.

Brain HealthCirculatory System

When blood flow to part of the brain stops for a short period of time it is called a transient ischemic attack, abbreviated as a TIA. Some people may call it a “mini-stroke” because in many ways it appears to be a stroke. The difference being, with a TIA the blood flow blockage resolves, and the blood begins to flow again with all the symptoms disappearing. Whereas with a stroke the blood flow remains blocked and the brain will have permanent damage.

When symptoms first appear, there is no way to tell if the person is going to experience a TIA or have a life-threatening stroke. Either way, you must call for emergency services ASAP. If it turns out to be a TIA, consider yourself lucky, but also considerer yourself warned that a full-blown life-threatening stroke may be “right around the corner”. Statistics show that 40% of people who have a TIA will have a more severe stroke in the future, particularly in the weeks and months following the TIA. This is why it’s important to be aware of the symptoms of a TIA and to take steps to reduce your risk.

What are the causes and risk factors of a TIA?

Loss of blood supply to portions of the brain may occur for a variety of reasons. When a blood vessel is blocked, blood supply to a part of the brain is lost. This blockage can also cause blood to leak into the brain (brain hemorrhage). In most cases of TIAs, the blood vessel is blocked. The blockage can be caused by a blood clot that forms in the blood vessel (thrombosis) or it can be caused by a clot or debris that has broken loose from a thrombosis elsewhere in the body and is floating in the blood stream towards the brain (embolus).

Risk Factors:

  • Prior history or family history of TIAs: Prior TIA makes one 10 times more likely to have a stroke and the risk may generally be greater if a family member has suffered from a TIA or stroke.
  • High Blood Pressure: Increases the risk of developing an embolism
  • Age: Risk increases with advancing age, particularly after you surpass the age of 55.
  • Poor nutrition: High fat and salt intake, along with increased weight contributes to your increased risk of TIA and stroke.
  • Cardiovascular disease: Specifically, atrial fibrillation.
  • Diabetes: This increases the severity and progression of atherosclerosis
  • Elevated homocysteine levels: This amino acid in the blood can cause arteries to thicken and scar, thereby increasing the susceptibility to clots.
  • Smoking: Cigarette smoking increases the risk of blood clots, elevates blood pressure and contributes to the development of atherosclerosis.
  • Alcohol abuse

What are the symptoms of a TIA?

The symptoms of a TIA are similar to those of a stroke. However, many people make the mistake of not seeking medical treatment since the symptoms are less severe and don’t last long. While the symptoms of a stroke can last for more than 24 hours, the symptoms of a TIA typically go away after a few minutes or hours.

The common signs of a TIA include: sudden increase in blood pressure, unilateral muscle weakness often expressed as an asymmetry of facial muscles, temporary numbness in an arm or leg, dizziness, sudden fatigue, unconsciousness, confusion, temporary memory loss, body tingling, personality changes, difficulty speaking or speaking “gibberish”, poor balance and possible changes in vision.

How is the cause of a TIA diagnosed?

Even though TIA symptoms go away fairly quickly, you should never ignore a TIA. A TIA is a warning sign that you’re at risk for having a stroke in the future. Getting prompt medical treatment is critical to lowering the risk of having a life-threatening or disabling stroke.

One of the most common diagnostic tests used is a carotid Doppler ultrasound. This is a safe, noninvasive test that uses high-frequency sound waves to create detailed images of the carotid arteries in your neck. Your carotid arteries carry blood from your heart to your brain. The pictures produced allow your doctor to check for narrowing of the carotid arteries. When the arteries narrow, your risk of stroke increases.

MRI and CT scans are also often used to determine the underlying cause of a TIA. Your doctor may order an echocardiogram if they suspect that a problem with your heart triggered the transient ischemic attack.

What is the treatment for a TIA?

After a TIA has been diagnosed, the cause of the attack must be determined, and you and your medical provider will come up with a treatment to correct the abnormality and prevent a stroke. Treatment may include medication, surgery, or a combination of both.

The medicine and therapy used depends on the exact cause of the TIA. Medications to treat high blood pressure, high cholesterol, or heart disease are first line treatments. Lifestyle changes such as diet, physical activity, limiting alcohol intake, and not smoking are extremely important. These changes may reduce your risk of another TIA or more severe stroke.

If a TIA is caused by blockage in the main artery in the neck that supplies blood to the brain (the carotid artery) surgeries may be required to open the artery and prevent a severe stroke. These procedures are known as endarterectomy and stenting.

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