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Some people call a transient ischemic attack (TIA) a mini-stroke, because the symptoms are like those of a stroke but don't last long. A TIA happens 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. With a stroke, the blood flow stays blocked, and the brain has permanent damage.
A TIA is a warning: it means you are likely to have a stroke in the future. If you think you are having a TIA, call 911. Early treatment can help prevent a stroke. If you think you have had a TIA but your symptoms have gone away, you still need to call your doctor right away.
Symptoms of a TIA are the same as symptoms of a stroke. But symptoms of a TIA occur suddenly and don't last very long. Most of the time, they go away in 10 to 20 minutes. They may include:
A blood clot is the most common cause of a TIA. Blood clots can be the result of hardening of the arteries (atherosclerosis), heart attack, or abnormal heart rhythms. Brain cells are affected within seconds of the blockage. That causes symptoms in the parts of the body controlled by those cells. After the clot dissolves, blood flow returns, and the symptoms go away.
Sometimes a TIA is caused by a sharp drop in blood pressure that reduces blood flow to the brain. This is called a "low-flow" TIA. It is not as common as other types.
Your doctor will do tests to look at your heart and blood vessels. You may need:
Your doctor will also check to see if something else is causing your symptoms.
Your doctor will start you on medicines to help prevent a stroke. You may need to take several medicines.
If tests show that the blood vessels (carotid arteries) in your neck are too narrow, you may need surgery to open them up (carotid endarterectomy). This can help prevent blood clots that block blood flow to your brain.
Another type of surgery is carotid artery stenting. During this surgery, the doctor puts a small tube called a stent inside your carotid artery. This helps keep the artery open. Carotid artery stenting is not as common as endarterectomy.
After you have had a TIA, you are at risk for having another TIA or a stroke. But you can make some important lifestyle changes that can reduce your risk of stroke and improve your overall health.
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Blood clots that temporarily block blood flow to the brain are the most common cause of transient ischemic attacks (TIAs). Blood clots may develop for a variety of reasons.
Also, an artery that is partially blocked with plaque can reduce blood flow to the brain and cause symptoms.
Rare causes of blood clots that can cause a TIA include:
A TIA is a warning: It means you are likely to have a stroke in the future. If you think you are having a TIA, call 911. Early treatment can help prevent a stroke. If you think you had a TIA but your symptoms went away, you still need to call your doctor right away.
Symptoms of transient ischemic attacks (TIAs) occur suddenly and are always temporary. They usually go away in 10 to 20 minutes. TIA symptoms are just like stroke symptoms. They vary depending on which part of the brain is affected. Common symptoms of TIA may include:
If symptoms last longer than an hour, it might be more likely that you have had a stroke.
A transient ischemic attack (TIA) is a warning sign that a stroke may soon follow. Any symptoms of a TIA need to be treated as an emergency.
A TIA also may signal an increased risk for a heart attack. Atherosclerosis, which is hardening of the arteries, affects blood vessels throughout the body, including arteries that supply blood to the heart and brain. Atherosclerosis that affects the blood vessels in the heart (coronary arteries) may cause chest pain or a heart attack.
The risk factors (things that increase risk) for transient ischemic attack (TIA) and stroke include those you can treat or change and those you can't change.
Risk factors you can treat or change include:
Risk factors you cannot change include:
Call 911 or other emergency services immediately if you have:
Call your doctor immediately if you have:
Call your doctor today if you think you have had a TIA in the past and have not yet talked with your doctor about your symptoms.
The following doctors can diagnose and treat a transient ischemic attack (TIA):
Other specialists may be consulted if you need surgery or have other health problems:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Immediate evaluation is recommended if you have had or are having a transient ischemic attack (TIA). The purpose of evaluation is to:
If your TIA symptoms have completely disappeared, the results of a physical exam will be normal, and the diagnosis of a TIA usually will be based on your medical history and certain tests.
If a TIA is suspected, the doctor may want to do tests, such as a:
Further tests are often done to identify the cause of the TIA. If blockage of the carotid arteries is suspected, you may have tests such as:
TIA symptoms may be due to blood clots caused by a heart problem. If heart problems are suspected, you may have tests such as a:
You may have other blood tests, such as a complete blood count (CBC), chemistry screen, and prothrombin time based on your age and medical history. Your doctor will use these tests to look for other causes of the TIA.
If you have symptoms of a TIA, get medical help right away.
If you had symptoms of a TIA but you feel better now, you still need to see a doctor right away. A TIA is a sign that a stroke may soon follow. Prompt medical treatment may prevent a stroke.
If you've had a transient ischemic attack (TIA), you may need further testing and treatment after you've been checked by your doctor. If you have a high risk of stroke, you may have to stay in the hospital for treatment.
Your treatment for a TIA may include taking medicines to prevent a stroke or having surgery to reopen narrow arteries.
Medicines may include aspirin, clopidogrel, dipyridamole with aspirin, or warfarin.
If your carotid arteries are significantly blocked, you may need surgery to reopen the narrowed arteries (carotid endarterectomy).
Your treatment will also focus on preventing another TIA or stroke. This may include:
You may also need to make lifestyle changes such as quitting smoking, eating heart-healthy foods, and being more active.
You can help prevent a transient ischemic attack (TIA) or stroke by controlling your risk factors for stroke.
These are some of the common risk factors for stroke:
Home treatment is not appropriate for a transient ischemic attack (TIA). If you think you are having a TIA, don't ignore the symptoms, and don't try to manage them at home. If you had symptoms of a TIA but they went away, you still need to see a doctor right away.
Seek emergency medical care when symptoms first appear. Prompt treatment may keep you from having a stroke.
You can care for yourself at home by adopting healthy habits that help you prevent another TIA or stroke. To learn more, see Prevention.
Your doctor will probably prescribe several medicines after you have had a transient ischemic attack (TIA). Medicines to prevent blood clots are typically used, because blood clots can cause TIAs and strokes.
The types of medicines that prevent clotting are:
Cholesterol-lowering and blood pressure-lowering medicines are also used to prevent TIAs and strokes.
Antiplatelet medicines keep platelets in the blood from sticking together.
Anticoagulants such as warfarin (for example, Coumadin) prevent blood clots from forming and keep existing blood clots from getting bigger. You may need to take this type of medicine after a TIA if you have atrial fibrillation or another condition that makes you more likely to have a stroke. For more information, see the topic Atrial Fibrillation.
Statins lower cholesterol and can greatly reduce the risk of stroke in people who have had a TIA. Statins even protect against stroke in people who don't have heart disease or high cholesterol.2
If you have high blood pressure, your doctor may want you to take medicines to lower it. Blood pressure medicines include:
If you have a serious blockage in the carotid arteries in your neck, you may need a carotid endarterectomy. During this surgery, a surgeon removes plaque buildup in the carotid arteries to reduce the risk of transient ischemic attack (TIA) or stroke.
The benefits and risks of this surgery must be carefully weighed, because the surgery itself may cause a stroke. Your need to have carotid endarterectomy depends on whether you have had a TIA or stroke and how much your carotid arteries have narrowed.
Carotid artery stenting (also called carotid angioplasty and stenting) is sometimes done as an alternative to surgery to prevent transient ischemic attack (TIA) or stroke. In this procedure, a doctor threads a thin tube called a catheter through an artery in the groin and up to the carotid artery in your neck. The doctor then uses a tiny balloon to enlarge the narrowed portion of the artery and places a stent to keep the artery open. Carotid artery stenting is not as common as carotid endarterectomy.
The National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health, is the leading U.S. federal government agency supporting research on brain and nervous system disorders. It provides the public with educational materials and information about these disorders.
The Society of Interventional Radiology is a national organization of physicians, scientists, and health professionals dedicated to improving public health through disease management and minimally invasive, image-guided therapies. Intervention radiology includes using X-rays, MRI, and other imaging to move a thin tube in the body, usually in an artery, to treat a disease. An example is angioplasty for heart disease. The Web site includes a section on patient information. This section gives information on therapies for various diseases and conditions. The Web site can also help you find a doctor.
Visit the American Heart Association (AHA) website for information on physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your nearest local or state AHA group. The AHA provides brochures and information about support groups and community programs, including Mended Hearts, a nationwide organization whose members visit people with heart problems and provide information and support.
CardioSmart is an online education and support program that can be your partner in heart health. This website engages, informs, and empowers people to take part in their own care and to work well with their health care teams. It has tools and resources to help you prevent, treat, and/or manage heart diseases.
You can set health and wellness goals and track your progress with online tools. You can track your weight, waist measurement, blood pressure, and activity. You can use calculators to help you find your body mass index (BMI) and check your risk for heart problems. You can search for a cardiologist. And you can find medicine information and prepare for your next appointment. Also, you can join online communities to connect with peers and take heart-healthy challenges.
CardioSmart was designed by cardiovascular professionals at the American College of Cardiology, a nonprofit medical society. Members include doctors, nurses, and surgeons.
The U.S. National Heart, Lung, and Blood Institute (NHLBI) information center offers information and publications about preventing and treating:
This association provides education, information, referrals, and research on stroke. Information specific to survivors, caregivers, family, women, and children is included.
CitationsRoger VL, et al. (2011). Heart disease and stroke statistics 2011 update: A report from the American Heart Association. Circulation, 123(4): e18–e209.Furie KL, et al (2011). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 42(1): 227–276. Also available online: http://stroke.ahajournals.org/content/42/1/227.full.Other Works ConsultedBiller J, et al. (1998). Guidelines for carotid endarterectomy: A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Circulation, 97(5): 501–509. Also available online: http://circ.ahajournals.org/content/97/5/501.full.Easton JD, et al. (2009). Definition and evaluation of transient ischemic attack: A scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council. Stroke, 40(6): 2276–2293. Also available online: http://stroke.ahajournals.org/cgi/reprint/40/6/2276.ESPRIT Study Group (2006). Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): A randomized controlled trial. Lancet, 367(9523): 1665–1673.Rothwell PM, et al. (2007). Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): A prospective population-based sequential comparison. Lancet, 370(9596): 1432–1442.Skinner JS, Cooper A (2011). Secondary prevention of ischaemic cardiac events, search date May 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458–2473. Also available online: http://circ.ahajournals.org/content/124/22/2458.full.U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx.
Last Revised: September 19, 2011
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine & Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
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