Transient Ischemic Attack
Transient ischemic attack (TIA) is a brief problem of the brain. It is due to a shortage of blood and oxygen. TIA is sometimes called a mini-stroke.
TIA is a serious problem. It is a warning of a future stroke.
|Blood Supply to the Brain|
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TIA happens when blood flow to the brain is too low. This can be from a narrowing or a blockage. Narrowing may happen with:
- A build up of plaque, called atherosclerosis
- Vasculitis—inflammation of the blood vessels
A blockage may happen with:
- A piece of a blood clot or plaque that has broken off from another site
Blood and blood-clotting problems, such as:
- Severe anemia—too few red blood cells
- Polycythemia—too many red blood cells
- Hyperviscosity—thickening of the blood
- Endocarditis—an infection of the lining of the heart
TIAs are more common in older adults. Some things that may raise the risk of TIA are:
- A history of TIAs
- Atrial fibrillation (AF) or other heart problems
- Metabolic syndrome
- Alcohol use disorder
- High cholesterol
TIA symptoms happen quickly. The problems a person has depends on the part of the brain that is affected. Symptoms are like those of a stroke.
- Loss of strength
- Problems speaking
- Problems seeing, such as blindness in one eye
- Numbness or tingling
- A feeling of spinning when you are still
The doctor will ask about symptoms and past health. A physical exam will be done. Tests that may be done include:
- Blood tests
- MRI scan of the head
- MR angiography to assess blood vessels in the head using magnetic imaging
- CT scan of the head
- CT angiogram to assess blood vessels in the brain and neck with contrast dye
- Doppler ultrasound to assess blood flow in the arteries supplying the brain
- Electrocardiogram (EKG) to measure the heart's electrical activity
The effects of TIA do not last. Most people recover in a few minutes. However, a TIA means there is an increased risk of a stroke. The risk is highest in the first week after a TIA. The goal of treatment is to lower the risk of a future stroke. Medical care is needed to make the best plan for prevention. Steps may include:
- Lifestyle changes, such as not smoking, eating a healthful diet, exercising, and limiting alcohol
- Medicines to prevent blood clots or to slow clotting
- Surgery to ease blockage in blood vessels
- Managing health problems, such as diabetes, high blood pressure, or high cholesterol
TIA cannot always be prevented. To lower the risk:
- Manage high blood pressure.
- Avoid using tobacco.
- Limit alcohol.
- Maintain a healthy weight through diet and exercise.
- Duca A, Jagoda A. Transient Ischemic Attacks: Advances in Diagnosis and Management in the Emergency Department. Emerg Med Clin North Am. 2016 Nov;34(4):811-835.
- Risk factors for stroke or transient ischemic attack. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/risk-factors-for-stroke-or-transient-ischemic-attack. Accessed October 5, 2020.
- Sangha RS, Caprio FZ, et al. Quality of life in patients with TIA and minor ischemic strokes. Neurology. 2015;85(22):1957-1963.
- Transient ischemic attack information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Transient-Ischemic-Attack-Information-Page. Accessed October 5, 2020.
- Transient ischemic attack (TIA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/transient-ischemic-attack-tia. Accessed October 5, 2020.