Transient ischemic attack
Mini stroke; TIA; Little stroke; Cerebrovascular disease - TIA; Carotid artery - TIAA transient ischemic attack (TIA) occurs when blood flow to a part of the brain stops for a brief time. A person will have stroke-like symptoms for up to 24 hours. In most cases, the symptoms last for 1 to 2 hours.
A transient ischemic attack is a warning sign that a true stroke may happen in the future (often near future) if something is not done to prevent it.
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark ArticleCauses
A TIA is different than a stroke. After a TIA, the blockage breaks up quickly and dissolves on its own. A TIA does not cause brain tissue to die.
The loss of blood flow to an area of the brain can be caused by:
- A blood clot in an artery of the brain
- A blood clot that travels to the brain from somewhere else in the body (for example, from the heart)
- An injury to blood vessels
- Narrowing of a blood vessel in the brain or leading to the brain
High blood pressure is the main risk factor for TIAs and stroke. Other major risk factors are:
High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
Read Article Now Book Mark ArticleRisk factors
A stroke occurs when blood flow to a part of the brain suddenly stops. A stroke is sometimes called a "brain attack or cerebrovascular accident. " I...
Read Article Now Book Mark Article- Irregular heartbeat called atrial fibrillation
Atrial fibrillation
Atrial fibrillation (Afib) and atrial flutter are common types of abnormal heart rhythms (arrhythmias) which affect the upper chambers (atria) of the...
Read Article Now Book Mark Article -
Diabetes
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article - Family history of stroke
- Being male
-
High cholesterol
High cholesterol
Cholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol in your blood can increase your chance of...
Read Article Now Book Mark Article - Tendency to have abnormal blood clotting
- Increasing age, especially after age 55
- Ethnicity (African Americans are more likely to die of stroke)
- Smoking
- Alcohol use
- Recreational drug use
- History of prior TIA or stroke
People who have heart disease or poor blood flow in their legs caused by narrowed arteries are also more likely to have a TIA or stroke.
Poor blood flow in their legs
Peripheral artery disease (PAD) is a condition of the blood vessels that supply the legs and feet. It occurs due to narrowing of the arteries in the...
Read Article Now Book Mark ArticleSymptoms
Symptoms begin suddenly, last a short time (from a few minutes to 1 to 2 hours), and go away. They may occur again at a later time.
The symptoms of a TIA are the same as the symptoms of a stroke, and include:
- Change in alertness (including sleepiness or unconsciousness)
- Changes in the senses (such as hearing, vision, taste, and touch)
- Mental changes (such as confusion, memory loss, difficulty writing or reading, trouble speaking or understanding others)
- Muscle problems (such as weakness, trouble swallowing, trouble walking)
- Dizziness or loss of balance and coordination
- Lack of control over the bladder or bowels
- Sensation problems (such as numbness or tingling on one side of the body)
Exams and Tests
While the symptoms and signs of a TIA may go away by the time you get to the hospital, it is important to be evaluated right away. In the event your symptoms don't go away, all treatments are more effective the sooner they are given. Someone with a TIA is also very likely to have a stroke in the following days to weeks. A TIA diagnosis may be made based on your medical history alone.
Your health care provider will do a complete physical exam to check for heart and blood vessel problems. You will also be checked for nerve and muscle problems.
Your provider will use a stethoscope to listen to your heart and arteries. An abnormal sound called a bruit may be heard when listening to the carotid artery in your neck or other artery. A bruit is caused by irregular blood flow.
Tests will be done to rule out a stroke or other disorders that may cause the symptoms:
- You will likely have a head CT scan or brain MRI. A stroke may show changes on these tests, but TIAs will not.
Head CT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
Read Article Now Book Mark ArticleBrain MRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
Read Article Now Book Mark Article - You may have an angiogram, CT angiogram, or MR angiogram to see which blood vessel is blocked or bleeding.
Angiogram
An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain...
Read Article Now Book Mark Article - You may have an echocardiogram if your provider thinks you may have a blood clot from the heart.
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
Read Article Now Book Mark Article - You may have a
carotid duplex ultrasound. It can show if the carotid arteries in your neck have narrowed.
Carotid duplex ultrasound
Carotid duplex is an ultrasound test that shows how well blood is flowing through the carotid arteries. The carotid arteries are located in the neck...
Read Article Now Book Mark Article - You will likely have an electrocardiogram (ECG) and heart rhythm monitoring tests to check for an irregular heartbeat.
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
Read Article Now Book Mark ArticleHeart rhythm monitoring
A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.
Read Article Now Book Mark Article
Your provider may do other tests to check for high blood pressure, heart disease including an irregular heartbeat, diabetes, high cholesterol, and other causes of, and risk factors for TIAs or stroke. You may have an EEG test to check if your symptoms are not due to a seizure.
Treatment
If you have had a TIA within the last 48 hours, you will likely be admitted to the hospital so that doctors can search for the cause and monitor you.
High blood pressure, heart disease, diabetes, high cholesterol, and blood disorders will be treated as needed. You will be encouraged to make lifestyle changes to reduce your risk of further symptoms. Changes include quitting smoking, exercising more, and eating healthier foods.
Quitting smoking
There are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...
Read Article Now Book Mark ArticleYou may receive blood thinners, such as aspirin, heparin, warfarin (Coumadin), or direct acting oral anticoagulants (DOACs) to reduce blood clotting. Some people who have blocked neck arteries may need surgery (carotid endarterectomy). If you have an irregular heartbeat (atrial fibrillation) or other heart problems, you will be treated to avoid future complications.
Aspirin
Current guidelines recommend that people with coronary artery disease (CAD) receive antiplatelet therapy with either aspirin or clopidogrel. Aspirin ...
Read Article Now Book Mark ArticleCarotid endarterectomy
Carotid artery surgery is a procedure to treat carotid artery disease. The carotid artery brings needed blood to your brain and face. You have one o...
Read Article Now Book Mark ArticleOutlook (Prognosis)
TIAs do not cause lasting damage to the brain.
But, TIAs are a warning sign that you may have a true stroke in the coming days or months. Some people who have a TIA will have a stroke within 3 months. Half of these strokes happen during the 48 hours after a TIA. The stroke may occur that same day or at a later time. Some people have only a single TIA, and others have more than one TIA.
You can reduce your chances of a future stroke by following up with your provider to manage your risk factors.
When to Contact a Medical Professional
A TIA is a medical emergency. Call 911 or the local emergency number right away. Do not ignore symptoms just because they go away. They may be a warning of a future stroke.
Prevention
Follow your provider's instructions on how to prevent TIAs and strokes. You will likely be told to make lifestyle changes and take medicines to treat high blood pressure or high cholesterol.
References
Biller J, Ruland S, Schneck MJ. Ischemic cerebrovascular disease. In Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. Philadelphia, PA: Elsevier; 2022:chap 65.
Gladstone DJ, Lindsay MP, Douketis J, et al. Canadian stroke consortium. Canadian stroke best practice recommendations: secondary prevention of stroke Update 2020. Can J Neurol Sci. 2022;49(3):315-337. PMID: 34140063 pubmed.ncbi.nlm.nih.gov/34140063/.
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):3234-3237. PMID: 30423391 pubmed.ncbi.nlm.nih.gov/30423391/.
January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS focused updated of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(1):104-132. PMID: 30703431 pubmed.ncbi.nlm.nih.gov/30703431/.
Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021;52(7):e364-e467. PMID: 34024117 pubmed.ncbi.nlm.nih.gov/34024117/.
Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.
Papa L, Meurer WJ. Stroke. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 87.
Riegel B, Moser DK, Buck HG, et al; American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017;6(9):e006997. PMID: 28860232 pubmed.ncbi.nlm.nih.gov/28860232/.
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;72(3):e127-e248. PMID: 29133354 pubmed.ncbi.nlm.nih.gov/29133354/.
-
Stroke
Animation
-
Endarterectomy - illustration
Endarterectomy is a surgical procedure removing plaque material from the lining of an artery.
Endarterectomy
illustration
-
Transient Ischemic attack (TIA) - illustration
A transient ischemic attack (TIA) is caused by a temporary state of reduced blood flow in a portion of the brain. This is most frequently caused by tiny blood clots that temporarily occlude a portion of the brain. A primary blood supply to the brain is through two arteries in the neck (the carotid arteries) that branch off within the brain to multiple arteries that supply specific areas of the brain. During a TIA, the temporary disturbance of blood supply to an area of the brain results in a sudden, brief decrease in brain function.
Transient Ischemic attack (TIA)
illustration
-
Endarterectomy - illustration
Endarterectomy is a surgical procedure removing plaque material from the lining of an artery.
Endarterectomy
illustration
-
Transient Ischemic attack (TIA) - illustration
A transient ischemic attack (TIA) is caused by a temporary state of reduced blood flow in a portion of the brain. This is most frequently caused by tiny blood clots that temporarily occlude a portion of the brain. A primary blood supply to the brain is through two arteries in the neck (the carotid arteries) that branch off within the brain to multiple arteries that supply specific areas of the brain. During a TIA, the temporary disturbance of blood supply to an area of the brain results in a sudden, brief decrease in brain function.
Transient Ischemic attack (TIA)
illustration
-
Transient ischemic attacks
(Alt. Medicine)
-
Heart attack and acute coronary syndrome - InDepth
(In-Depth)
-
Stroke - InDepth
(In-Depth)
Review Date: 4/29/2023
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.