Pronounced: trans-EE-ent isk-EE-mik uh-tak
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 stroke . 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:
TIAs may be caused by high blood pressure , diabetes , atrial fibrillation , or blood clotting disorders. Factors that increase your chance for TIA and stroke are similar:
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:
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:
A TIA places you at greater risk for having a stroke. The risk is actually highest in the first week after your TIA. Therefore, rapid treatment aims to decrease stroke risk . This can be done with lifestyle changes, medication, and surgery. If the cause of the TIA is a treatable condition it must be promptly treated. Specific conditions include:
Smokers must quit . Patient with diabetes, hypertension , and/or high cholesterol must make every effort to manage these conditions. It can be done with:
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:
If the carotid artery on the same side as the TIA is 70% blocked or more, doctors may recommend:
These procedures have risks associated with them. Talk to your doctor about your options. They are often not done if there are no symptoms and less than 70% blockage.
The following strategies may help reduce the chance of TIAs and stroke:
RESOURCES:
American Heart Association
http://www.americanheart.org/
National Stroke Association
http://www.stroke.org/
CANADIAN RESOURCES:
Canadian Society for Vascular Surgery
http://csvs.vascularweb.org/
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/
References:
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.
Last reviewed October 2009 by Rimas Lukas, MD
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 medical condition.
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