A TIA, or transient ischemic attack, is a temporary blockage of blood flow to a part of the brain. By definition, a TIA lasts less than 24 hours, and it does not cause permanent brain injury. TIAs are sometimes referred to as “mini strokes,” but this is a confusing term, as they are not strokes. Although a TIA is not a stroke, it is often treated similarly long term. However, the distinction is important. TIAs do not cause permanent damage to the brain because the blood clot dissolves on its own or the brain quickly adapts by rerouting blood flow.
A TIA has symptoms that are very similar to a stroke, but they are brief, typically lasting only minutes to up to 24 hours in duration.
Common TIA symptoms include:
Weakness on one side of the body
Facial droop or weakness
Numbness on one side of the body
Vision loss
Speech problems or trouble communicating
Dizziness or balance problems
TIAs can have a multitude of causes. Risk factors for TIAs include high blood pressure, diabetes, smoking and high cholesterol. Another common cause is heart disease, such as heart rhythm disturbances, heart failure and heart valve disorders.
Less common causes include arterial dissection, patent foramen ovale (PFO), and genetic or acquired clotting conditions.
The most important step in treating TIA is to get to the emergency department as soon as possible.
After a TIA has occurred, a thorough workup is needed to determine the cause. Testing may include blood work, imaging of the brain and its blood supply, and cardiac testing. Vitals signs need to be carefully monitored to ensure that blood flow to the brain is optimized as much as possible. Testing not only helps clarify the cause of the TIA, but it also may help determine the risk for recurrence.
Most of the time, blood thinners are prescribed to reduce the risk of having a stroke. Sometimes, urgent revascularization of an artery is needed if a major artery to the brain has severe narrowing.
Fortunately, because TIAs are transient and result in no permanent damage to the brain, recovery is swift and complete.
As a neurologist at Northwestern Medicine Central DuPage Hospital, I find that physicians may refer to a TIA as a “warning” because they often precede an actual ischemic stroke. Approximately 1 in 3 people who have a TIA will go on to have a stroke, roughly half of those people within a year.
For this reason, it’s important to take TIAs very seriously. When you heed the warning a TIA represents, steps can be taken to prevent a true ischemic stroke from taking place.
Stroke prevention is the primary reason patients need to be evaluated immediately after having a TIA. Several risk factors increase the risk of subsequent stroke, including:
Age over 60 years of age
Weakness or speech disturbance at the onset of symptoms
Duration of symptoms greater than 60 minutes
The presence of significant narrowing of a major artery to the brain also increases the risk for recurrence.
Medications such as blood thinners, blood pressure and cholesterol-lowering agents, and diabetes medications are often required to address these risk factors.
While medications help, lifestyle factors also play a significant role in reducing the risk for stroke.
Smoking cessation is very important.
A diet that includes more fruit and vegetables and less fat, sodium and added sugars is recommended.
Physical activity and regular exercise are also beneficial.
Sometimes, other medical problems that can increase risk for stroke, such as sleep apnea and cancer, need to be addressed.
For more information on stroke: