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A transient ischemic attack (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. Some people call a TIA a mini-stroke, because the symptoms are those of a stroke but don't last long.
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 or other emergency services right away. 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 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 form when blood vessels are damaged by high blood pressure, high cholesterol, or hardening of the arteries (atherosclerosis). An abnormal heart rhythm called atrial fibrillation also can lead to blood clots. The clot can block blood flow to part of the brain. 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 caused 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 a procedure to open them up. This can help prevent blood clots that block blood flow to your brain.
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 transient ischemic attack (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 or other emergency services right away. 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:
A transient ischemic attack (TIA) is a warning sign that a stroke may soon follow. After a TIA, you have a higher risk of having a stroke. 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. If you have atherosclerosis in arteries to your brain, you may also have it in arteries to your heart (coronary artery disease). If you have coronary artery disease, you are at risk for 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 now if you have signs of a stroke:
Call your doctor right away 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:
Your doctor will ask you about your medical history and do a physical exam.
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 (INR) 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 transient ischemic attack (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 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 narrowed, you may need a procedure to widen the arteries. This may prevent another TIA or a stroke.
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. For more information, see Prevention.
You can help prevent a transient ischemic attack (TIA) or stroke if you control risk factors and treat other medical conditions that can lead to a stroke. You can help prevent a TIA or stroke by taking steps toward a heart-healthy lifestyle.
Your doctor can help you know your risk. 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. Call 911 or other emergency services right away. If you had symptoms of a TIA but they went away, you still need to see a doctor right away.
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.
These medicines include:
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 stroke if you have atrial fibrillation or another condition that makes you more likely to have another stroke. For more information, see the topic Atrial Fibrillation.
Statins lower cholesterol and the risk for a TIA or stroke.
If you have high blood pressure, your doctor may want you to take medicines to lower it. Blood pressure medicines include:
When surgery is being considered after a transient ischemic attack (TIA), your age, prior overall health, and current condition are major factors in the decision.
If you have 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. The benefits and risks of this surgery must be carefully weighed, because the surgery itself may cause a stroke.
Carotid artery stenting (also called carotid angioplasty and stenting) is sometimes done as an alternative to surgery to prevent a 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, a type of surgery.
CitationsBenjamin EJ, et al. (2017). Heart disease and stroke statistics-2017 update: A report from the American Heart Association. Circulation, 135(10): e146-e603. DOI: 10.1161/CIR.0000000000000485. Accessed January 26, 2017.Other Works ConsultedEaston 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; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. 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.Goff DC Jr, et al. (2013). 2013 ACC/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online November 12, 2013. DOI: 10.1161/01.cir.0000437741.48606.98. Accessed November 22, 2013.Kernan WN, et al. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7): 2160-2236. DOI: 10.1161/STR.0000000000000024. Accessed July 22, 2014.Lansberg MG, et al. (2012). Antithrombotic and thrombolytic therapy for ischemic stroke. Antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2, Suppl): e601S-e636S. Also available online: http://journal.publications.chestnet.org/article.aspx?articleid=1159534.Meschia JF, et al. (2014). Guidelines for the primary prevention of stroke: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, published online October 28, 2014. DOI: 10.1161/STR.0000000000000046. Accessed October 29, 2014.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.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.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineMartin J. Gabica, MD - Family MedicineKathleen Romito, MD - Family MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerRichard D. Zorowitz, MD - Physical Medicine and Rehabilitation
Current as ofMarch 20, 2017
Current as of: March 20, 2017
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
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