Transient Ischemic Attack (TIA)

Overview

A transient ischemic attack, or TIA, is a brief episode of stroke-like symptoms. It indicates a temporary (transient) reduction in blood supply to an area of the brain. When there is not enough blood flow, brain cells malfunction and begin to die (ischemia). The majority of TIAs are brief and don’t result in long-term harm.

Similar to an ischemic stroke, a transient ischemic attack is a medical emergency. This is because there is no way to predict how long a transient is going to last and every minute counts. Seek immediate medical attention if someone displays stroke symptoms, such as drooping arms and face, poor speech, vision changes, or balance issues.

Experiencing a TIA, also referred to as a ministroke, should be a cause for significant concern. It is important to note that approximately 1 in 3 TIA patients are at risk of eventually suffering a full-blown stroke, with around half of these strokes occurring within a year following the initial TIA episode. Moreover, aside from serving as an opportunity for timely intervention and treatment, a TIA can also function as a critical warning sign for a potential future stroke.

Symptoms

Transient ischemic attacks often last for a short period of time. While uncommon cases may result in symptoms lasting up to 24 hours, the majority of signs and symptoms go away in an hour. Early-stage symptoms of a stroke are similar to those of a transient ischemic attack (TIA), which might include sudden onset of:

• Weakness, numbness, or paralysis, usually on one side of the body, in the arm, leg, or face
• Difficulty understanding others or slurred speech.
• sudden loss of one or more senses (hearing, taste, smell, vision, and touch), either completely or partially.
• Loss of balance, vertigo, or coordination
• Memory loss.
• Sudden headache.

The patient may experience many transient internal seizures (TIAs), with repeated signs and symptoms that vary depending on the specific brain region affected.

Transient ischemic attacks (TIAs) usually occur hours or days before a stroke, therefore it’s important to get medical assistance as soon as possible.

Causes

An ischemic stroke, the most common kind of stroke, has similar causes as a transient ischemic attack. Part of the brain’s blood supply is cut off during an ischemic stroke due to a clot. A transient ischemic attack (TIA) does not result in permanent damage and the blockage is temporary.

Atherosclerotic plaques, characterized by the buildup of cholesterol-laden fat deposits, tend to amass in the arteries or their branches responsible for supplying the brain with vital oxygen and nutrients. These plaques often serve as the primary underlying cause of transient ischemic attacks (TIAs).

These plaques have the potential to induce the formation of blood clots or restrict the flow of blood within an artery. Additionally, a TIA can be triggered when a blood clot from another part of the body, typically the heart, travels to an artery that provides blood to the brain.

Risk factors

A TIA may be caused by or more likely to occur as a result of numerous circumstances. The following risk factors for a TIA and stroke cannot be changed by the patient. However, being aware of their risk may encourage them to alter their way of life in order to lower additional risks. Among the risk factors are:

• Family history: If a family member has suffered a stroke or TIA, the risk could be higher.
• Age: As the patient ages, the risk increases, particularly around age 55.
• Sex: A TIA and a stroke are slightly more common in men. However, the risk of stroke increases with age in women.
• History of transient ischemic attack: An increased risk of stroke occurs if the patient has experienced one or more TIAs.
• Sickle cell disease: One of the most common side effects of sickle cell disease is stroke. Blood vessels with a sickle form tend to clog arteries and carry less oxygen, which reduces blood flow to the brain. On the other hand, people can reduce their risk of stroke by receiving the right treatment for sickle cell disease.
• Controllable risk factors: Many factors, such as specific medical disorders and lifestyle decisions, can be managed or controlled by the patient to lower their risk of stroke. A person’s likelihood of having a stroke rises if they have two or more of these risk factors, although having one or more of them does not guarantee it.
  • Weight: Obesity raises the risk of stroke in both men and women, particularly when it involves excess weight around the abdomen.
  • Tobacco usage: For a lower chance of a TIA and stroke, give up smoking. Atherosclerosis, or the buildup of cholesterol-containing fatty deposits in the arteries, is one of the risks associated with smoking, along with blood clots and abnormal blood pressure.
  • Physical activity: Regularly completing 30 minutes of moderate-intense exercise lowers risk.
  • Poor nutrition: Lowering salt and fat intake also lowers the risk of stroke and transient ischemic attack.
  • Alcohol intake: If the patient drinks, they should restrict their intake to no more than two drinks for men and one drink for women each day.
  • Illegal drugs: Don’t use cocaine or any other illegal substances.
  • High cholesterol: Reducing cholesterol and fat intake, particularly trans and saturated fat, may help to lessen artery-clogging plaque. A statin or other cholesterol-lowering medicine may be prescribed by the healthcare provider if the patient’s cholesterol cannot be controlled by dietary modifications alone.
  • High blood pressure: When blood pressure measurements exceed 140/90 millimeters of mercury (mm Hg), the risk of a stroke increases. The patient and the healthcare provider will choose an appropriate target blood pressure based on the patient’s age, the presence of diabetes, and other relevant considerations.
  • Diabetes: Atherosclerosis is a condition in which fatty deposits build up in the arteries, narrowing them. Diabetes makes this condition worse and progress more quickly.
  • Cardiovascular disease: This includes abnormal cardiac rhythms, heart defects, infections, and heart failure.
  • Carotid artery disease: This disease causes blockages in the neck blood arteries that supply the brain.
  • Peripheral artery disease (PAD): The blood arteries that supply blood to the arms and legs clog as a result of PAD.
  • High homocysteine level: Increased blood concentrations of this amino acid can lead to artery scarring and thickening, which increases the risk of blood clots.