What Is A Transient Ischemic Attack?
Transient ischemic attack (TIA) is a term used to describe temporary stroke-like symptoms. TIA is a medical emergency that signals a high risk of impending stroke. Patients often do not recognize the symptoms of TIA, but it is imperative that regardless of the duration or severity, symptoms of TIA should be treated in the same manner as acute ischemic stroke. The risk of stroke is highest within the first 48 hours of a TIA; an emergency department is most efficient in identifying those at highest risk for stroke.
Stroke vs. TIA
In a TIA the interruption is temporary; in most cases, the clot breaks up quickly. In a stroke, the clot or blockage remains much longer, resulting in damage to brain tissue. The longer a stroke is untreated, the greater the damage to the brain. It is very important to act quickly. Because the symptoms of a TIA and a stroke are the same, those experiencing symptoms should be taken to the emergency department immediately for comprehensive, expedited assessment and treatment.
Recognizing the importance of this emergency service, Rhode Island Hospital has a dedicated TIA unit within its Andrew F. Anderson Emergency Center. We realize that this is often a patient’s first contact in a health care setting for evaluation for TIA or possible stroke, and we are committed to optimal assessment and care within this critical timeframe.
What causes a transient ischemic attack (TIA)?
Both a TIA and a stroke are caused by an interruption in the flow of blood to the brain The three causes of attacks are:
- Low blood flow at a narrowing of a major artery that transports blood back to the brain, such as the carotid artery
- A blood clot that occurs in another part of the body and breaks off, traveling to the brain and blocking a blood vessel in the brain
- Narrowing of a smaller blood vessel in the brain due to plaque build-up, causing short-term blockage of blood flow
In extremely rare instances, a TIA may be caused by a small amount of bleeding within the brain, known as a hemorrhage.
What are the warning signs of a TIA?
Transient ischemic attacks typically last a short time – from a few minutes to 30 minutes. In rare cases, they may persist for up to 24 hours. The signs and symptoms of a TIA include:
- Sudden numbness or weakness in the face, arm, or leg, particularly on one side of the body.
- Sudden confusion.
- Sudden difficulty speaking.
- Sudden difficulty seeing in one or both eyes.
- Sudden difficulty walking.
- Sudden dizziness, loss of balance, or coordination.
- Sudden and severe headache without a known cause.
It is possible to experience multiple TIAs, and the recurring signs and symptoms may vary depending on the specific region of the brain involved.
How is a TIA diagnosed?
At first, medical professionals may quickly test eyesight, speech, thought processes, and strength. After the initial tests, patients may receive diagnostic testing scanning of the carotid arteries and brain that will help identify potential areas of plaque build-ups. The diagnostic tests may include carotid ultrasonography, computerized tomography (CT), magnetic resonance imaging (MRI), echocardiography, or arteriography. It is important to note that no single test can diagnose a TIA. Since the attacks are temporary, damage may not appear on test scans. In some cases, doctors choose not to use those types of tests for that reason.
How common are TIAs?
Roughly 240,000 people a year in the United States have transient ischemic attacks, according to the American Heart Association.
Who is at risk for a TIA?
Smoking, high blood pressure, a family history of strokes or TIAs, and diabetes increase the risk of transient ischemic attacks. People 55 years old and older and those with imbalances in their lipid profiles are more likely to have TIAs, as well. In addition, race, gender, and genetics play factors.
Can TIAs lead to permanent brain damage?
Think of transient ischemic attacks as early warning signals. They may look like strokes, but they usually do not have lasting effects. TIAs do not cause permanent brain damage or neurological issues.
What is the long-term outlook for someone who has had a TIA?
Each person’s individual health impacts the prognosis after having a transient ischemic attack. The attacks themselves minimally impact health, but they signal more serious health issues, such as strokes. Approximately ten percent of people seen for TIAs experience strokes within 90 days. Therefore, it is important for patients to monitor their health closely and work with their physicians.