Transient Ischemic Attack (TIA)

What is transient ischemic attack (TIA)?

A transient ischemic attack (TIA) is a stroke. It is not a major stroke. In fact, it is often called a “mini” or “warning” stroke. If you have a mini stroke, the blood flow to your brain is blocked for two to five minutes. That is much less than a major stroke. There is usually no long-term damage. However, having a mini stroke significantly increases your risk of having a major stroke.

What are the symptoms of transient ischemic attack (TIA)?

Mini stroke symptoms are similar to those of a major stroke. You may have weakness and loss of feeling in your face, arm, or leg. It usually occurs on one side of your body, which is another warning sign. You may have trouble smiling or speaking because of the facial weakness. You also may have difficulty understanding others, or you may feel confused. You may have a severe headache that comes on suddenly, have trouble seeing, feel dizzy, and have trouble walking, balancing, or with your coordination.

What causes transient ischemic attack (TIA)?

A blood clot is almost always the cause of a mini stroke, just as it is in a major stroke. Blood clots are often caused by cholesterol buildup. When too much cholesterol blocks your arteries, it causes a blood clot to form and travel to your brain. That’s where the mini stroke occurs. Managing your cholesterol levels through diet, exercise, and medicine prescribed by your doctor can lower your risk of a mini stroke.

Other medical conditions, such as high blood pressure, diabetes, and obesity are linked to strokes. They also can be managed through lifestyle changes and prescription medicine. Not smoking and limiting alcohol will lower your risk of stroke. Other risks for stroke include age, heredity, gender, and ethnicity. If you’ve already had a stroke, you are at a much higher risk of having another one.

How is transient ischemic attack (TIA) diagnosed?

To diagnose a mini stroke, your doctor or an emergency room doctor will perform a physical exam and ask you about your medical history (including whether you have a history of diabetes, high cholesterol, high blood pressure, recent trauma to the head or neck, or if you are a cigarette smoker). A mini stroke only lasts minutes. So all tests and exams will happen after you report your symptoms to your doctor or arrive at the emergency room.

During the exam, your doctor will move a stethoscope around your chest and back to listen for sounds of a heart murmur or irregular heartbeat. These sounds are common in someone who has hardening of the arteries, a risk factor for stroke. Your doctor also will look at your eyes. He or she is looking for tiny bits of cholesterol or bleeding at the back of your eye. This is another sign of stroke.

Certain imaging tests can be used to take pictures of the inside your body and diagnose stroke. These imaging tests include:

  • Carotid ultrasonography
  • CT (computerized tomography)
  • CTA (computerized tomography angiography)
  • MRI (magnetic resonance imaging)
  • MRA (magnetic resonance angiography)
  • TTE (transthoracic echocardiogram)
  • TEE (transesophageal echocardiogram)

Finally, a small surgical test called an arteriography can diagnose a mini stroke. This test allows your doctor to look at the arteries in your brain. The test involves making a small incision (cut) near your groin (lower abdomen). A flexible tube attached to a camera is inserted into the incision and moved around to give your doctor the view he or she needs to make a diagnosis.

Can transient ischemic attack (TIA) be prevented or avoided?

Healthy living and managing any chronic diseases you may have can decrease your risk of a mini stroke. This includes maintaining a healthy diet, regular exercise, not smoking, limiting alcohol, and taking your prescription medicines as directed. It is a helpful approach whether you know you are at risk or not. See your doctor if you believe your medical history, family history, or other factors put you at a higher risk or stroke. A mini stroke is a red flag for a future, major stroke or another mini stroke. Without proper lifestyle changes and medicine, a second mini stroke or major stroke can happen within 1 year of your first mini stroke. Even with healthy changes, there’s no guarantee you won’t have a stroke.

Transient ischemic attack (TIA) treatment

Just like a major stroke, a mini stroke is an emergency and requires immediate attention. When treating all strokes, time is critical. The sooner you are treated, the better your recovery and outcome. Treatment may include blood clot medicine (which you may be required to take for the rest of your life to prevent blood clots that could lead to future strokes), surgery (to open a clogged artery), or both. Another surgery called endarterectomy is sometimes performed on people with an extremely narrow neck artery. This procedure cleans fatty cholesterol deposits from that artery.

Living with transient ischemic attack (TIA)

Long-term damage, such as difficulty walking or speaking, is rare after having a mini stroke. Some people are anxious and worried about the possibility of having another mini stroke, even after making healthy living changes and taking their prescription medicine. Therefore, it’s important to learn the signs and symptoms of strokes. The phrase FAST will help you remember the symptoms.

  • F — Face. If you are unable to smile, if your face is drooping (especially on one side), you may be having a stroke.
  • A — Arms. If you are unable to raise one or both arms, you may be having a stroke.
  • S — Speech. If you cannot speak, repeat a simple phrase, or your speech is slurred, you may be having a stroke.
  • T — Time. Time is the most important factor in treating a stroke successfully. Receiving treatment within 3 hours of your symptoms provides the best outcome and recovery.

Teach your family and friends the FAST rule in case you are unable to communicate your symptoms or what you are feeling.

Sign explaining the warning signs and symptoms of a stroke (FAST acronym)

Questions to ask your doctor

  • Am I at greater risk of stroke if one or both of my parents or a sibling has had one?
  • Can certain medicines cause a stroke?
  • Can caffeine cause a stroke?
  • What should I do if I am more than 3 hours away from a hospital when I recognize my symptoms?
  • What are the complications of an untreated stroke?