Transient Ischemic Attack (TIA)

What is a transient ischemic attack (TIA)?

A transient ischemic attack (TIA) is a brief loss in brain function. It happens when the brain does not get enough blood because blood flow is blocked or decreased for a short time. The symptoms go away when the blood flow becomes normal again.

What is the cause?

A TIA may be caused by anything that blocks blood flow to part of the brain for a short time. Blood flow is most often blocked or decreased by a blood clot. Blood clots can be caused by:

  • Fatty deposits called plaque that build up in blood vessels and make them narrower. Pieces of plaque may break off from the wall of a blood vessel and form clots that can block blood flow to the brain, causing a TIA.
  • Small blood clots moving to the brain from the heart. For example, people with an abnormal heart rhythm or a mechanical heart valve may form clots in the heart.
  • A heart attack

You are more likely to have a TIA or stroke if you have a medical condition that puts a strain on your heart and blood vessels such as:

  • High blood pressure
  • Diabetes or metabolic syndrome
  • High cholesterol
  • Blood vessel disease
  • Heart rhythm or heart valve problems
  • Sickle cell anemia
  • Sleep apnea

Some unhealthy lifestyle habits can increase your risk for a TIA or stroke. You are more likely to have a stroke if you:

  • Smoke
  • Eat an unhealthy diet
  • Are overweight
  • Don't get enough exercise
  • Use illegal drugs or too much alcohol

Your risk is also greater if you have had a TIA or stroke before.

What are the symptoms?

Symptoms of TIA and stroke are the same, except TIA symptoms go away within 24 hours and stroke symptoms may not. It helps to think of the word FAST (face, arm, speech, time) to remember TIA and stroke symptoms and what to do. The symptoms come on FAST and may include:

  • Face/Head
    • Weakness, numbness, drooping, or tingling of face (may just be on one side)
    • Trouble seeing (one or both eyes)
    • Severe headache
    • Trouble thinking
    • Trouble swallowing
    • Feeling dizzy along with one or more of the symptoms listed above
  • Arm/Leg
    • Weakness, numbness, or tingling in your arm or leg (may be on just one side of your body)
    • Trouble walking or moving your arm or leg
  • Speech
    • Trouble talking or understanding speech
  • Time
    • Call 911 for emergency help right away if you have symptoms of a TIA or stroke.

The symptoms start without warning and usually last less than 5 minutes.

A TIA is different from a stroke because it does not cause any lasting damage to the brain. The effects of a TIA are usually gone within 24 hours. However, even if your symptoms are gone within 24 hours, it's possible that there is brain damage and you have had a stroke.

If you have had a TIA, you have a high risk of having a stroke. Do not ignore symptoms of a TIA. Get emergency medical care to help prevent a stroke and to be tested to see if your symptoms were caused by blockage of your carotid arteries.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

  • MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the brain and blood vessels
  • CT scan, which uses X-rays and a computer to show detailed pictures of the brain and blood vessels
  • Ultrasound, which uses sound waves to show pictures of the blood vessels in the neck and brain
  • Cerebral angiogram, which uses dye injected into a vein and X-rays to look at blood flow in the brain
  • An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat. You may have an ECG while you are resting or while you exercise on a treadmill. You may also be asked to wear a small portable ECG monitor for a few days or longer.
  • An echocardiogram, which uses sound waves (ultrasound) to see how well your heart is pumping
  • Blood tests

How is it treated?

You may need to stay in the hospital if you have a high risk of stroke. The goal of treatment is to prevent more blockage and stroke.

Your healthcare provider may prescribe medicine that helps prevent blood clots or medicine to lower cholesterol. Your provider may tell you to take a low-dose aspirin every day. Aspirin lowers the chance that blood clots will form and lowers your risk of having a stroke caused by a blood clot. However, some strokes are caused by bleeding and aspirin may increase your risk of having this type of stroke. If you are having sudden symptoms of a stroke, do not take aspirin unless recommended by your healthcare provider.

If your carotid artery is severely blocked, you will likely need a procedure to open the blood vessel.

  • Carotid endarterectomy involves making cuts in your neck and the artery and then removing the blockage.
  • Carotid angioplasty and stenting involves passing a balloon-tipped tube (catheter) into the blocked artery in your neck. Once the catheter is in the proper place, the balloon is inflated to open the blood vessel and improve blood flow. A metal mesh device called a stent is usually left in the artery to help keep the blood vessel open.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Take any medicines exactly as prescribed. Don’t take any other medicines, including nonprescription drugs, without letting your provider know.

Try to have a healthy lifestyle:

  • Eat a healthy diet.
  • Try to keep a healthy weight. If you are overweight, lose weight.
  • Stay fit with the right kind of exercise for you.
  • If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
  • If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.

Get your blood pressure and cholesterol levels checked by your healthcare provider regularly.

If you have high blood pressure, high cholesterol, diabetes, or another medical problem, follow your treatment plan.

Ask your provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent a TIA?

Talk to your healthcare provider about your personal and family medical history and your lifestyle habits. This will help you know what you can do to lower your risk for carotid artery disease. Taking good care of your health, including a healthy lifestyle, can help prevent TIAs.

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Published by RelayHealth.
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