Download Transient Ischemic Attack

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John Q. Patient
Dr. Smith
Neurology
617-555-1212
September 1, 2015
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Transient Ischemic Attack
(TIA; Mini-Stroke)
Pronounced: trans-EE-ent isk-EE-mik uh-tak
Definition
Transient ischemic attack (TIA) is a temporary dysfunction of the brain due to a shortage of blood and oxygen.
A TIA lasts no longer than 24 hours. It is sometimes referred to as a mini-stroke.
TIA is a serious condition. It serves as a warning for a potential stroke.
Blood Supply to the Brain
Copyright © Nucleus Medical Media, Inc.
Causes
Blood and oxygen are carried to the brain through major blood vessels in the neck. The blood then passes
through a series of blood vessels in the brain. A TIA occurs when the blood flow through the neck or brain
vessels is reduced. The blood flow may be reduced by a narrowing or blockage of the blood vessels.
Narrowing of the blood vessels may occur with:
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Build up of plaque in the blood vessels, called atherosclerosis
Vasculitis—inflammation of the blood vessels
Blood vessels can also become blocked or obstructed by a clot or clump that is floating in the blood. This may be caused
by:
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A piece of blood clot or plaque that has broken off of another location
Blood and blood-clotting disorders such as:
o Severe anemia —too few red blood cells
o Polycythemia —too many red blood cells
o Hyperviscosity—abnormal thickening of the blood
Endocarditis —an infection of the lining of the heart
Risk Factors
Certain chronic medical conditions can affect the health of your blood vessels. These conditions may increase
your chances of TIA:
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Diabetes
Obesity
Metabolic syndrome
Heart disease
TIAs are more common in men than women in younger age groups. They are also more common in people age
45 years or older, with the highest risk between ages 60-80 years. Other factors that increase your chance for
TIA include:
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History of previous TIAs
Smoking
Poor diet
Sedentary lifestyle
Alcohol use disorder
Sleep apnea
Low bone mineral density, especially in women
Vascular dementia
Symptoms
TIA symptoms occur abruptly. They usually last less than an hour, but they may persist for up to 24 hours. The
symptoms are different depending on the part of the brain that is affected. TIA symptoms are similar to those
of a stroke and need immediate medical attention.
Symptoms may include:
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Blindness in one eye, often described as a window shade dropping, and/or other visual problems
Weakness, numbness, or tingling of the face, arm, leg, or one side of the body (usually affects one side of the
body, but there are exceptions)
Difficulty speaking or understanding words
Lightheadedness, unsteadiness of gait, or falling
Trouble with balance or coordination
Loss of consciousness
Nausea
Vomiting
Sudden confusion or loss of memory
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor will
carefully assess your blood pressure and nervous system. The main goal of tests or questions will be to
determine your stroke risk.
Tests may include:
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Blood tests
Electrocardiogram (EKG)—to measure your heart's electrical activity
Doppler ultrasound —to assess blood flow in the arteries supplying the brain
Echocardiogram —to look for blood clots and valve abnormalities within the heart
CT scan of the head
CT angiogram—to assess blood vessels in the brain and neck with contrast dye
MRI of the head
MR angiography—to assess blood vessels in the head using magnetic imaging
Arteriogram—to locate and assess blockage or narrowing of blood vessels using contrast dye
Treatment
A TIA places you at greater risk for having a stroke. The risk is actually highest in the first week after your TIA.
Therefore, rapid treatment aims to decrease your risk of stroke. This can be done with lifestyle changes,
medication, and surgery.
Lifestyle
Smokers must quit. Talk with your doctor about the smoking cessation programs.
People with diabetes, high blood pressure, and/or high cholesterol must make every effort to manage these
conditions. It can be done with:
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Regular exercise under the guidance of your doctor
Appropriate dietary changes—low in saturated fat, and rich in whole grains, fruits, and vegetables
Other lifestyle interventions, such as monitoring alcohol intake
Medications
The doctor may also prescribe medications to lower blood sugar, blood pressure, and cholesterol. This will
help lower these risk factors.
To decrease the risk of clot formation your doctor may recommend antiplatelet agents such as aspirin.
If the blood clot came from your heart due to atrial fibrillation, anticoagulants may be prescribed.
Surgery
If you have at least a 70% blockage in your carotid artery (in your neck), doctors may recommend:
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A carotid endarterectomy to remove the plaque deposits
Other less invasive procedures, such as intra-arterial stenting to widen an artery
These procedures have risks associated with them. Talk wth your doctor about your options.
Treatment of Underlying Conditions
If the cause of the TIA is a treatable condition, it must be promptly treated. Specific conditions that need
further treatment include:
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Atrial fibrillation
Severe anemia
Vasculitis
Prevention
To reduce your chance of TIA or stroke, take these steps:
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Exercise regularly, with your doctor's approval.
Eat a healthy, balanced diet. It should be low in saturated fat and rich in whole grains, fruits, and vegetables.
Maintain a healthy weight.
If you smoke, find out ways you can successfully quit.
Drink alcohol in moderation. Moderate alcohol intake is no more than two drinks per day for men and one drink
per day for women.
Control blood pressure, high cholesterol, and diabetes if you have these conditions.
Last Reviewed: June 2015 Rimas Lukas, MD
Updated: 8/11/2015
Published by EBSCO Publishing. This content is reviewed regularly and is updated when new and relevant
evidence is made available. This information is neither intended nor implied to be a substitute for professional
medical advice. Always seek the advice of your physician or other qualified health provider prior to starting
any new treatment or with questions regarding a medical condition.