Transient ischemic attack

Definition

A transient ischemic attack 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 (TIA) is felt to be a warning sign that a true stroke may happen in the future if something is not done to prevent it.

Causes

A TIA is different than a stroke. After a TIA, the blockage breaks up quickly and dissolves. A TIA does not cause brain tissue to die.

The loss of blood flow to an area of the brain can be caused by:

High blood pressure is the main risk for TIAs and stroke. Other major risk factors are:

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.

Symptoms

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 TIA are the same as the symptoms of a stroke, and include:

Exams and Tests

Often, the symptoms and signs of a TIA will have gone away by the time you get to the hospital. A TIA diagnosis may be made based on your medical history alone.

The 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.

The doctor 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 the 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:

Your doctor may do other tests to check for high blood pressure, heart disease, diabetes, high cholesterol, and other causes of, and risk factors for TIAs or stroke.

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 observe 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.

You may receive blood thinners, such as aspirin or Coumadin, to reduce blood clotting. Some people who have blocked neck arteries may need surgery (carotid endarterectomy). If you have an irregular heartbeat (atrial fibrillation), you will be treated to avoid future complications.

Outlook (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. More than 10% of 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 another 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.


Review Date: 6/1/2015
Reviewed By: Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and Immediate Past President of the Florida Society of Neurology (FSN), Gainesville, FL. Review provided by VeriMed Healthcare Network. Internal review and update on 07/24/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

This information should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. © 1997- 2007 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.