Transient Ischemic Attack – Causes and Treatment

Definition

A transient ischemic attack, or TIA, is often described as a mini-stroke. Unlike a stroke, however, the symptoms can disappear within a few minutes. TIAs and strokes are both caused by a disruption of the blood flow to the brain. In TIAs and most strokes, this disruption is caused by a blood clot blocking one of the blood vessels leading to the brain.

WHAT YOU SHOULD DO

·    Always take your medicine as directed by your doctor. If you feel it is not helping, call your doctor, but do not quit taking it on your own.
·    If you take aspirin regularly, continue taking it. Aspirin helps thin the blood so blood clots don’t form. Do not take acetaminophen or ibuprofen instead.

What are the symptoms of a TIA?
The common symptoms of a TIA are similar to those of a stroke, but are temporary in duration. TIAs can sometimes cause nausea or vomiting. Symptoms occur suddenly and reach their maximum intensity quickly. These symptoms may include:
·    Sudden dizziness
·    Sudden numbness or weakness in an arm, leg, or on one side of the body
·    Drooping of one side of the face
·    Sudden loss of balance and coordination
·    Sudden difficulty in speaking or in understanding speech

How Risky Are Transient Ischemic Attacks?

Two presentations at the conference looked at the risk of stroke and death after a transient ischemic attack. The first study compared the risk of stroke, dependency, and death in transient ischemic attack and stroke patients in Germany. Although stroke patients were at a higher risk in each category, patients who had a transient ischemic attack still had a high likelihood of having a stroke (6%), becoming dependent on others for daily care (22%), and dying (2%) within six months of the transient ischemic attack. The researchers concluded that transient ischemic attacks “merit the same attention” as strokes.

What causes a transient ischemic attack?

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. Once the clot dissolves, blood flow returns, and the symptoms go away.

Diagnosis

If you have had a stroke or a TIA and your doctor suspects that you may have a significant degree of stenosis in your carotid arteries, she or he will conduct an examination consisting of specific tests to determine the extent of the carotid artery disease including:
·    Duplex ultrasound
·    Cerebral angiogram
·    Magnetic Resonance Angiogram (MRA)
·    CT scan

Treatments of Transient Ischemic Attack discussion: Because there is no way to tell whether symptoms are from a TIA or an acute stroke, patients should assume that all stroke-like symptoms signal an emergency and should not wait to see if they go away. A prompt evaluation (within 60 minutes) is necessary to identify the cause of the TIA and determine appropriate therapy.