MRI of the brain shows a very small stroke; therefore, this patient did NOT have a TIA.
Transient Ischemic Attack, or TIA
- A term for neurologic symptoms, such as weakness or numbness, which begin suddenly and resolve completely and are caused by a temporary lack of blood in an area of the brain.
- TIAs are common, affecting approximately 240,000 people each year in the United States.
- Anyone who has had a TIA is at risk for a stroke in the future. As a result, it is important to be aware of the signs and symptoms of TIA and seek treatment as soon as possible.
- TIAs usually last less than ten minutes; the average is about a minute. Rarely, the duration can be hours. With a longer duration, it is more likely that a stroke occurred.
- Unlike a stroke, there is no permanent injury to the brain after a TIA. Therefore, it is wrong to use the terms TIA and "mini-stroke" interchangeably. After a TIA, MRI imaging should NOT show a stoke; see the MRI above.
- A transient ischemic attack is an episode in which a person has signs or symptoms of a stroke (eg, localized numbness, weakness, dyscoordination; inability to speak).
- A person may have one or many TIAs.
- People recover completely from symptoms of a TIA, otherwise it is not a TIA.
Immediate treatment can decrease the risk. It is important to get help right away if you think you may be having a TIA or a stroke.
Carotid artery blockage: Some TIAs result from blockages in the major arteries to the brain, such as the carotid arteries. (See also Carotid Artery Blockage).
Atherosclerosis: Other TIAs are due to blockage of small arteries inside the brain. These blood vessels provide oxygenated blood to brain cells. The arteries can become clogged with fatty deposits, called plaques. The process of clogging of the arteries is an aging effect of the vascular system called atherosclerosis.
Emboli: In some cases, TIAs can be caused by blood clots that form in the heart and travel to the brain, called emboli.
TIAs can also occur as a result of the closure of small blood vessels deep inside the brain. If an artery remains blocked for more than a few minutes, the brain can become infarcted; this is a stroke or CVA (cerebrovascular accident), leaving the brain tissue permanently damaged and dead.
- Following a TIA, the symptoms resolve fairly quickly and no evidence of brain injury or infarction is seen on a brain scan
- With a stroke, symptoms may or may not resolve, but a brain scan shows injury or infarction. If the symptoms resolve quickly, but a new lesion appears on the scan, it is a CVA, not a TIA.
Symptoms of TIA all occur very suddenly:
- Hand, cheek, face, arm, or leg weakness, clumsiness, or numbness on one side of the body; or any combination of these, but typically always on the right or the left side of the body
- Difficulty speaking, garbled speech, slurred speech, or inability to speak at all. Inability to choose the correct words
- Difficulty understanding language, spoken or written.
- Confusion or loss of memory
- Double vision
- Loss of vision (one eye; or the same visual field to either right or left of both eyes)
- Inability to stand or walk
- Dizziness or vertigo; sudden loss of hearing. Other medical conditions than vascular more often explains these symptoms
- Neck or back pain rarely are associated with stroke
- Headaches are usually due to other conditions than TIA or CVA.
However, headache can accompany other symptoms of stroke. Yet, headaches are significant features of certain types of stroke with bleeding into the brain, including the catastrophic subarachnoid hemorrhage from ruptured cerebral aneurysm.
TIA Risk Factors:
- Age greater than 50 years; higher risk with age.
- Heart disease (ex: atrial fibrillation, valvular disease, aortic stenosis, heart attack)
- Atherosclerosis and other vascular disease
- Carotid artery disease
- High blood pressure
- High blood cholesterol and lipid levels
- Illegal drug use or heavy alcohol use
- Recent childbirth
- Previous history of transient ischemic attack
- Sedentary lifestyle and lack of exercise
- Current or past history of blood clots
- Family history of stroke or heart attack
"Time is Brain"
Symptoms of TIA are identical to those of a stroke. When the symptoms first develop, it is impossible to tell if a person is having a stroke or TIA. There is no way to predict which clots will dissolve on their own.
Stroke — and TIA — are medical emergencies;
dial 9-1-1 and tell the operator you think it’s a stroke and note the exact time the symptoms started.
Remember: Time lost is brain lost. A transient ischemic attack can serve as both a warning and an opportunity, — a warning of an impending stroke and an opportunity to take steps to prevent it.
Mark the exact time of onset of the symptoms and write it down, later to tell your doctors. Also, mark the exact time of resolution of the problem.
[edited from strokeassociation.org]
National Stroke Association
American Stroke Association