Transient ischemic attack (TIA) refers to temporary brain dysfunction. It lasts no longer than 24 hours. TIA is due to a shortage of blood and oxygen to the brain. It sometimes is referred to as a mini-stroke. TIA is a serious condition. It serves as a warning for a
. About 30% of stroke patients have had a TIA at some point in the past.
A TIA results from a temporary blockage of the blood supply to the brain. The carotid artery in the front of the neck is a major supply of blood to the brain. A build-up of plaque and hardening of this artery can slow or stop blood flow.
Reasons for the blockage may include:
A blood clot or a piece of plaque (called an embolus) from inside the wall of an artery breaks off and blocks blood flow to a portion of the brain.
A blood clot dislodges from the heart and moves to the brain.
Temporary low blood pressure in the brain may occur due to narrowed arteries in the neck.
TIA symptoms occur abruptly. They usually last less than 10 minutes. They may persist for up to 24 hours. The effects differ depending on the location of the blockage. TIA symptoms are similar to those of a stroke. They require immediate medical attention.
Symptoms may include:
Blindness in one eye, often described as a window shade dropping, and/or other visual problems
Weakness, numbness, or tingling of the face, arm, leg, or one side of the body (usually affects one side of the body, but there are exceptions).
Difficulty speaking or understanding words
Dizziness, unsteadiness of gait, or falling
Trouble with balance or coordination
Loss of consciousness
Sudden confusion or loss of memory
The doctor will ask about your symptoms and medial history. A physical exam will be done. Particular attention will be paid to your blood pressure and nervous system. A primary goal will be to determine your stroke risk.
Tests may include:
Blood tests—such as a complete blood count, blood sugar (glucose), cholesterol and other fat levels, clotting factors, and a check of other elements in the blood
(EKG)—to measure heart rhythm (which would be irregular in, for example, atrial fibrillation) and check for other signs of heart disease
Doppler ultrasound—a test that uses sound waves to help determine if there is compromised blood flow in the arteries supplying the brain
Echocardiogram—another ultrasound test to look for blood clots and valve abnormalities within the heart
CT scan of the head—a type of x-ray that uses a computer to create images of structures inside the head; in this case, to look for evidence of bleeding or other damage to the brain
CT angiogram—a CT scan which uses dye to evaluate the blood vessels in the brain and neck.
MRI scan of the head—a test that uses powerful magnetic radiowaves to create images of structures inside the head; in this case, to look for evidence of bleeding or other damage to the brain
In addition, doctors often prescribe medication to lower blood sugar, blood pressure, and cholesterol. This will help lower these risk factors. To decrease the risk of clot formation your doctor may recommend:
Amarenco P, Bogousslavsky J, Callahan A III, et al; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack.
N Engl J Med; 2006;355:549-59.
Dambro MR, Griffith JA, Winters R, et al.Griffith's 5-Minute Clinical Consult.
Lippincott Williams & Wilkins; 1999.
Duthie EH, Katz PR.
Practice of Geriatrics. 3rd ed. WB Saunders Co; 1998.
Lutsep HL. MATCH results: implications for the internist.
Am J Med. 2006;119:526.
National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/. Accessed July 7, 2009.
Primary Care Medicine. 4th ed. Lippincott Williams & Wilkins; 2000.
Rakel RE, Bope ET. Conn's Current Therapy. WB Saunders Co; 2001.
Tierney LM, Papadakis MA, McPhee SJ. Current Medical Diagnosis and Treatment. 44th ed. 2005.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a