Transient Ischemic Attack

When a person experiences short-term symptoms similar to those of a stroke, it is known as a transient ischemic attack (TIA). The primary cause of this condition is a blockage of the blood flow to the brain. In most cases, TIA lasts several minutes and does not provoke any long-term damage. In any case, this condition can be dangerous and approximately 30% of people with TIA will have a stroke. Sometimes, TIA is called a ministroke and it is a warning symptom of a future stroke or a good chance to prevent it.

Symptoms

Commonly, the duration of the TIA symptoms is several minutes. While some people get rid of symptoms within an hour, others may experience these symptoms for up to 24 hours. Generally, TIA and stroke symptoms are very similar and happen suddenly. Check below some symptoms:

Trouble understanding other people
Vision changes (including double vision, blindness, and others)
Dizziness
Loss of balance or coordination
Slurred speech
Weakness, numbness, or paralysis in different parts of the body including face, arm, leg, or one side of the body.

You may experience more than one TIA and symptoms depend on the affected brain part. Immediately contact a healthcare professional if you suspect you have TIA because your doctor will help to prevent a stroke. In addition, once you experience TIA, a stroke can appear within hours or days.

Causes

TIA and ischemic stroke causes are similar. These occur usually due to a blood clot that prevents the blood flow to the brain. Moreover, ischemic stroke is one of the most common stroke types. The only difference is that in TIA the blockage happens for a short period and does not cause any significant damage.

In most cases, TIA happens due to a buildup of cholesterol deposits (known as artery plaques). This is also called atherosclerosis and the blockage occurs in the arteries that supply the brain with oxygen and nutrients.

As a result, these plaques prevent blood flow through arteria and form a blood clot. Thus, when a blood clot moves to other parts of the body (such as the heart), TIA occurs.

Risk Factors

There are different factors that can contribute to or even cause TIA. Furthermore, some of them are preventable while others are not.

Unpreventable Risk Factors

Family history – Your risk of getting TIA increases significantly if you have a family member who has had a TIA or a stroke.
Age – People after 55 years old are more prone to develop a TIA.
Sex – Men and people assigned to males at birth (AMAB) are more likely to get TIA than women and people assigned to females at birth (AFAB). However, women’s risk of TIA also elevates with aging.
Prior transient ischemic attack – People who experience one or more TIA are more likely to develop a stroke.
Sickle cell disease – Another name for this condition is sickle cell anemia and it is one of the most common complications is stroke. It occurs due to a blockage on the artery walls or because sickle-shaped blood cells carry a decreased level of oxygen. Therefore, it negatively affects blood flow to the brain. However, with proper treatment, you can reduce your risk of developing a stroke.

Preventable Risk Factors

The following TIA and stroke risk factors can be treated. These include lifestyle choices and medical conditions. In case you experience one or more preventable risk factors it does not necessarily mean you will have a stroke but your risk increases significantly.

Medical Conditions

Hypertension (high blood pressure) – If your blood pressure is 140/90 millimeters of mercury (mm Hg) or higher, your risk of getting a stroke elevates. Blood pressure treatment can help you reduce the risk.
High cholesterol levels – You can decrease cholesterol levels by reducing the consumption of saturated and trans fat. Talk with your doctor about some dietary changes. However, if these do not help you and you still have increased levels of cholesterol, doctors may prescribe you some medications including statins.
Cardiovascular disease – For example, heart defects, heart infections, heart rhythm diseases, heart failure, and others.
Carotid artery disease – The blood vessels that are located in the neck and lead to the brain become clogged in people with this disease.
Peripheral artery disease (PAD) – This condition provokes blood vessels to become clogged. Usually, arms and legs blood vessels are affected.
Diabetes – This is a health condition that speeds up and worsens the artery narrowing.
High homocysteine levels – Scaring and thickening of the arteries can happen due to increased levels of amino acid in the blood.
Excessive weight – Obesity is a health condition that elevates stroke risk.
COVID-19 – Some research suggests that the virus that provokes COVID-19 also can elevate your risk of stroke.

Lifestyle Choices

Cigarette smoking – This factor increases the risk of blood clots and can lead to atherosclerosis development. Quit smoking to reduce the risk of TIA or stroke.
Physical inactivity – Those who never engage in physical activities also are at higher risk of getting TIA or stroke.
Poor nutrition – It is also advised to reduce the amount of fat and salt you consume.
Heavy drinking – Limit or avoid drinking alcohol because it also elevates your risk of stroke.
Use of recreational drugs

Diagnosis

Physicians usually will ask you some questions about your symptoms and medical history before diagnosing TIA. They can also perform some tests that will help to confirm the condition. For example:

Physical examination and tests – Doctors usually perform a physical and neurological examination. These tests are done to check your vision, eye movements, speech and language, strength, reflexes, and sensory system. Your doctor can also check you for stroke risk factors including hypertension, high levels of cholesterol, diabetes, and homocysteine levels.
Carotid ultrasonography – A carotid ultrasound is usually used if your doctor suspects you have TIA due to a carotid artery in the neck.
CT (computed tomography) or CTA (computerized tomography angiography) scans – These are usually done to check for blockages in the neck and brain arteries. Doctors will inject a contrast substance into the blood vessels before testing.
MRI (magnetic resonance imaging) or MRA (magnetic resonance angiography) – These tests help to make detailed images of the brain.
Echocardiography – This test helps to identify if a heart problem happens due to a blockage in the arteries. Another name for this test is transthoracic echocardiogram (TTE).
Arteriography – In case doctors do not notice anything using X-rays, they can perform this test which involves a thin and flexible tube through a small cut in the groin.

Treatment

The treatment’s goal is to prevent stroke and treat TIA. Sometimes people need blood clot medications or even surgery. Check below some treatment options used in the TIA treatment:

Anti-platelet medicines – One of the most common medications prescribed by doctors is Aspirin because it has low cost with the fewest adverse reactions. However, Clopidogrel is an alternative medicine for Aspirin. Some research showed that using both Clopidogrel and Aspirin at the same time can help to reduce the risk of a stroke more than using Aspirin alone. Additionally, physicians can also prescribe you Ticagrelor (reduces the risk of recurrent stroke), Dipyridamole (reduces blood clotting), and others.
Anticoagulants (blood thinners) – The most commonly prescribed medications are Heparin and Warfarin. However, if you experience atrial fibrillation, your doctor may prescribe you Apixaban, Rivaroxaban, Edoxaban, or Dabigatran to lessen the bleeding risk.

Surgery

This procedure is often used in people who have a narrowed carotid artery in the neck. It is known as carotid endarterectomy and it helps to remove fatty deposits from this artery before TIA or stroke happens.

Angioplasty

A surgery known as carotid angioplasty and stent placement involves a device looking like a balloon that helps to open a clogged artery.

Is it Possible to Prevent Transient Ischemic Attack?

Yes, the following tips can help you to reduce the risk of TIA. Check some examples below:

Quit smoking or never start
Reduce cholesterol and fat
Adopt a healthy diet rich in fruits and vegetables
Limit sodium consumption
Limit or avoid alcoholic beverages
Try to get and keep a healthy weight
Avoid the use of street drugs
Manage diabetes and hypertension

Frequently Asked Questions

What is the most effective treatment for TIA?

In most cases, physicians prescribe the following medications to treat TIA. Examples include Aspirin, Clopigorel, and a mix of Aspirin and extended-release Dipyridamole. Moreover, you should not use any of the previous medications without the doctor’s recommendation because it may lead to unwanted outcomes.

What are the possible complications of TIA?

Those who suffer from TIA may experience the following complications. These include blood clots (deep vein thrombosis or pulmonary embolism), swallowing problems, and urinary tract infections (UTIs).

What foods should be avoided by people with TIA?

It is advised to not eat too much food including processed foods, and foods high in salt. Moreover, you should not eat more than 6g of salt daily. Otherwise, you may experience hypertension. If you have other questions, ask your healthcare provider.