TRANSIENT ISCHEMIC ATTACK (TIA, MINI-STROKE)

A transient ischemic attack (TIA) occurs when blood flow to part of the brain is blocked or reduced, often by a blood clot. After a short time, blood flows again and the symptoms go away. While transient ischemic attack (TIA) is often labeled “mini-stroke,” it is more accurately characterized as a “warning stroke,” a warning you should take very seriously.

The only difference between a stroke and TIA is that with TIA the blockage is transient (temporary). TIA symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes; the average is about a minute. When a TIA is over, it usually causes no permanent injury to the brain. With a stroke, the blood flow stays blocked, and the brain has permanent damage.

Symptoms

  • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.

If you experience these symptoms, seek emergency medical attention immediately.

DIAGNOSIS

Your doctor will perform a physical examination, ask about your symptoms and discuss your medical history. He will suggest one or more diagnostic tests. These include:

  • Carotid ultrasonography uses high-frequency sound waves to produce images of structures in your neck and detect narrowing or clotting in the carotid arteries.
  • Computerized tomography (CT) scan combines a series of X-ray images taken from different angles and uses computer processing to create cross-sectional images, or slices, of internal organs. It can be used to look for evidence of stroke or other abnormalities.
  • Magnetic resonance imaging (MRI) uses a magnetic field and pulses of radio wave energy to create detailed images of internal organs. It can be used to look for evidence of stroke or other abnormalities.
  • CT angiography or MR angiography provides additional images of blood flow in the carotid arteries. A contrast dye is injected into a blood vessel, and a CT scan or MRI gathers images of your neck and brain
  • Echocardiography emits sound waves to produce images of different parts of your heart.
  • Arteriography produces images of arteries in your brain not normally seen in X-ray imaging.

 

TREATMENT

Treatment includes medications to prevent a stroke and surgery to reopen narrow arteries.

Medicines may include aspirin, clopidogrel, dipyridamole with aspirin, or warfarin. Aside from medications, lifestyle changes are also important in preventing another TIA or stroke. This may include:

  • Quitting smoking
  • Eating heart-healthy foods
  • Being more physically active
  • Reducing high blood pressure
  • Controlling diabetes

If your carotid arteries are significantly narrowed, you may need a procedure to widen the arteries. This may prevent another TIA or a stroke. During a carotid endarterectomy, a surgeon removes plaque buildup in the carotid arteries. The benefits and risks of this surgery must be carefully weighed, because the surgery itself may cause a stroke.

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