Transient ischemic attacks (TIAs)
Transient ischemic attacks (TIAs), often referred to as "mini-strokes," are temporary episodes of stroke-like symptoms caused by a brief interruption in blood flow to the brain. Unlike strokes, the symptoms of a TIA resolve completely within twenty-four hours. Common causes of TIAs include blood clots, plaque buildup in arteries, and severe arterial narrowing, with risk factors such as high blood pressure, high cholesterol, smoking, diabetes, age, and cardiac issues contributing to their occurrence. Symptoms can vary but may include unilateral weakness or numbness, temporary loss of vision, difficulty speaking, dizziness, and sudden loss of strength in the legs.
Although TIAs may seem less serious due to their transient nature, they are critical warning signs of a potential future stroke and warrant immediate medical attention. Prompt treatment can help prevent further brain damage and may involve emergency care, diagnostic imaging, and medications such as anticoagulants and antiplatelet drugs. Awareness of TIAs and their symptoms is crucial for timely intervention and improving long-term health outcomes.
Transient ischemic attacks (TIAs)
ALSO KNOWN AS: Ministrokes
ANATOMY OR SYSTEM AFFECTED: Blood vessels, brain, circulatory system
DEFINITION: Temporary interference with blood flow to the brain, resulting in transient strokelike symptoms
CAUSES: Temporary interruption of blood supply to brain from hemorrhage, embolism, severe narrowing in artery; risk factors include high blood pressure, high cholesterol, smoking, diabetes, advancing age, cardiac disease, stress, lack of physical activity, genetics
SYMPTOMS: In carotid arteries, weakness or numbness on one side, temporary loss of vision in one eye, difficulty speaking; in back of brain, dizziness, difficulty walking, drop attacks
DURATION: Acute episodes that resolve within twenty-four hours
TREATMENTS: Emergency care, sometimes surgery to clear blocked arteries, medications (anticoagulants, antiplatelet drugs, clopidogrel, ticlopidine, dipyridamole)
Causes and Symptoms
A transient ischemic attack (TIA) is very similar to a stroke. Most physicians define a TIA as an episode of strokelike symptoms that fully resolves within twenty-four hours. A stroke, on the other hand, is defined as an episode that produces neurological symptoms that are permanent.
Strokes and TIAs are caused when the blood supply to the brain is interrupted. This interruption may occur because of a hemorrhage in an artery in the brain. Other causes of stroke or TIA may include a blood clot or piece of plaque that breaks loose from somewhere else in the body and eventually lodges in an artery that feeds the brain, or from severe narrowing in an artery that feeds the brain. Symptoms from a stroke or TIA that originates in the carotid arteries (the main arteries in the front of the neck) include weakness or numbness on one side of the body, temporary loss of vision in one eye, and difficulty speaking. When the back of the brain is damaged, symptoms such as dizziness, difficulty walking, or a drop attack (sudden loss of leg strength) may occur.
One might think that since the symptoms of a TIA go away, such an attack is not a serious condition. However, a TIA is often a warning signal of an impending stroke. For this reason, anyone suffering a TIA should immediately seek medical attention.
The risk factors for TIA and stroke are similar. They include high blood pressure, high cholesterol, smoking, diabetes mellitus, advancing age, cardiac disease (especially irregular heart rhythm problems), stress, and lack of physical activity. Genetics can make one more likely to have a stroke or a TIA as well.
Treatment and Therapy
A person experiencing symptoms of a TIA should call paramedics to be seen in an emergency room immediately. Doctors can assess the patient’s situation and determine whether treatment can be initiated that will limit the amount of time that the brain is starved of oxygen. A stroke has been referred to as “brain attack” to underscore the need to seek prompt medical attention quickly, as one would for a heart attack.
Diagnostic tests will likely include magnetic resonance imaging (MRI) of the brain to check for hemorrhage or damage. Other tests may include magnetic resonance angiography (MRA) of the arteries or an ultrasound of the arteries that serve the brain. If these studies show a narrowing of the carotid arteries, then surgery can be done to remove the narrowed section before it causes more damage.
In some cases, medications will be used to lessen the risk of a full-blown stroke. They may include anticoagulants (blood thinners) and antiplatelet drugs such as aspirin, clopidogrel (Plavix), ticlopidine, and dipyridamole (Aggrenox). Drugs that lower cholesterol may also be prescribed.
Bibliography
Adams, Harold P., Jr., Vladimir Hachinski, and John W. Norris. Ischemic Cerebrovascular Disease. New York: Oxford UP, 2001. Print.
American Stroke Association. http://www.strokeassociation.org.
Chaturvedi, Seemant, and Steven R. Levine, eds. Transient Ischemic Attacks. Malden: Blackwell Futura, 2004. Print.
Kikuchi, H., ed. Strategic Medical Science against Brain Attack. New York: Springer, 2002. Print.
National Library of Medicine. "Transient Ischemic Attack." Medline Plus, 25 Apr. 2022, medlineplus.gov/ency/article/000730.htm. Web. Accessed 8 Apr. 2024.
Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Transient Ischemic Attack. Rev. ed. San Diego: Icon Health, 2004. Print.
"Transient Ischemic Attack (TIA)." Mayo Clinic. Mayo Foundation for Medical Education and Research, 10 June 2014. Web. 12 May 2016.
"What is TIA?" National Stroke Association. National Stroke Association, 2016. Web. 12 May 2016.
Wood, Debra. "Transient Ischemic Attack." Health Library.EBSCO Information Services, 25 May 2021, healthlibrary.epnet.com/GetContent.aspx?token=D39207C8-9100-4DC0-9027-9AC6BA11942D&chunkiid=11506. Web. Accessed 9 Aug. 2023.