Carl R. Darnall Army Medical Center - Health Library

Transient Ischemic Attack

(TIA; Mini-Stroke)

Pronounced: trans-EE-ent isk-EE-mik uh-tak

Definition

Transient ischemic attack (TIA) is a brief problem of the brain. It is due to a shortage of blood and oxygen. It is also called a mini-stroke.

TIA is a serious problem. It is a warning of a future stroke.

Blood Supply to the Brain

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Causes  ^

Blood and oxygen reach the brain through blood vessels in the neck. The blood then passes through blood vessels in the brain. A TIA is when blood flow is too low. It may be due to a narrowing or blockage.

Narrowing may happen with:

  • A build up of plaque, called atherosclerosis
  • Vasculitis—inflammation of the blood vessels

Blood vessels can also become blocked by a clot or clump in the blood. This may be from:

  • A piece blood clot or plaque that has broken off from another site
  • Blood and blood-clotting problems such as:
    • Severe anemia —too few red blood cells
    • Polycythemia —too many red blood cells
    • Hyperviscosity—thickening of the blood
  • Endocarditis —an infection of the lining of the heart

Risk Factors  ^

TIAs are more common in men and older adults.

Some long-term problems can impact your blood vessels. These problems may raise your TIA risk:

TIAs are more common in men than women in younger age groups. They are also more common in people age 45 years or older, with the highest risk between ages 60-80 years. Other factors that increase your chance for TIA include:

Symptoms  ^

TIA symptoms happen quickly. The ones you have depend on the part of the brain that is affected. Symptoms are like those of a stroke. You will need medical care right away.

You may have:

  • Loss of strength
  • Clumsiness
  • Problems seeing, such as blindness in one eye
  • Problems speaking
  • Numbness or tingling
  • A feeling of spinning when you are still

Diagnosis  ^

The doctor will ask about your symptoms and health history. A physical exam will be done. Your doctor will check your blood pressure and nervous system. The main goal of tests or questions will be to find out your stroke risk.

You may have:

Treatment  ^

A TIA places you at greater risk of a stroke. The risk is highest in the first week after your TIA. You will need to work to lower your risk. This can be done with lifestyle changes, medicine, and surgery.

Lifestyle

If you smoke, you will have to quit. Talk with your doctor about programs that may help.

People with diabetes, high blood pressure, or high cholesterol must work to manage these problems. It can be done with:

  • Regular exercise under the guidance of your doctor
  • Diet changes—low in saturated fat, and rich in whole grains, fruits, and vegetables
  • Stopping or limiting alcohol intake

Medications

The doctor may also advise medicines to lower blood sugar, blood pressure, and cholesterol. This will help lower these risks.

The doctor may also advise:

  • Medicine, like aspirin, to prevent blood clots
  • Medicine that slows clotting

Surgery

If you have a blockage in the artery in your neck, you may have:

  • A carotid endarterectomy to remove the plaque deposits
  • Other less invasive procedures, such as intra-arterial stenting to widen an artery

These surgeries have risks. Talk with your doctor about your options.

Treatment of Other Conditions

If the cause of the TIA is a treatable, it must be treated right away. These are health problems such as:

  • AF
  • Severe anemia
  • Vasculitis

Prevention  ^

To reduce your chance of TIA or stroke:

  • Exercise regularly. Get approval from your doctor first.
  • Eat a healthy, balanced diet. It should be low in saturated fat and rich in whole grains, fruits, and vegetables.
  • Stay at a healthy weight.
  • If you smoke, talk to your doctor about ways you can successfully quit.
  • Drink alcohol in moderation. This means no more than two drinks per day for men and one drink per day for women.
  • Control blood pressure, high cholesterol, and diabetes if you have these health issues.
RESOURCES:

American Heart Association
http://www.heart.org

National Stroke Association
http://www.stroke.org

CANADIAN RESOURCES:

Canadian Society for Vascular Surgery
http://canadianvascular.ca

Heart & Stroke Foundation
http://www.heartandstroke.com

REFERENCES:

Amarenco P, Bogousslavsky J, Callahan A 3rd, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355(6):549-559.

Lutsep HL. MATCH results: Implications for the internist. Am J Med. 2006;119(6):526.

Myint PK, Cleark AB, Kwok CS, et al. Bone mineral density and incidence of stroke: European prospective investigation into cancer-norfolk population-based study, systemic review, and meta-analysis. Stroke. 2014;45(2):373-382.

NINDS transient ischemic attack information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Transient-Ischemic-Attack-Information-Page. Accessed June 18, 2018.

Risk factors for stroke or transient ischemic attack. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T361037/Risk-factors-for-stroke-or-transient-ischemic-attack. Updated May 15, 2018. Accessed June 18, 2018.

Sangha RS, Caprio FZ, Askew R, et al. Quality of life in patients with TIA and minor ischemic strokes. Neurology. 2015;85(22):1957-63.

Transient ischemic attack (TIA). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116640/Transient-ischemic-attack-TIA. Updated June 4, 2018. Accessed June 18, 2018.

6/2/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T361037/Risk-factors-for-stroke-or-transient-ischemic-attack: Imfeld P, Bodmer M, Schuerch M, Jick SS, Meier CR. Risk of incident stroke in patients with Alzheimer disease or vascular dementia. Neurology. 2013;81(10):910-919.

Last reviewed June 2018 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 6/14/2018