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Transient Ischemic Attack

Definition

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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Causes

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

Risk Factors

TIAs are more common in older adults. Some things that may raise the risk of TIA are:

Symptoms

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
  • Clumsiness
  • Problems speaking
  • Problems seeing, such as blindness in one eye
  • Numbness or tingling
  • A feeling of spinning when a person is still

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Tests that may be done include:

Treatment

The effects of TIA do not last. Most people recover in a few minutes. However, a TIA means there is a higher 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 or vaping, 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

Prevention

TIA cannot always be prevented. To lower the risk:

  • Manage high blood pressure.
  • Avoid using tobacco or vaping.
  • Limit alcohol.
  • Keep a healthy weight through diet and exercise.

References

  • Katzan, I.L., Schuster, A., et al. Changes in health-related quality of life after transient ischemic attack. JAMA Network Open, 2021; 4(7): e2117403.
  • Lifestyle changes to prevent stroke. American Stroke Association website. Available at: https://www.stroke.org/-/media/Stroke-Files/Lets-Talk-About-Stroke/Prevention/Lifestyle-Changes-to-Prevent-Stroke.pdf.
  • 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.
  • Transient ischemic attack. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/disorders/transient-ischemic-attack.
  • Transient ischemic attack (TIA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/transient-ischemic-attack-tia.
 
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