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The disruption in blood supply results in a lack of oxygen to the brain. This can cause symptoms similar to those of astroke, such as speech and visual disturbance and numbness or weakness in the arms and legs. However, a TIA does not last as long a stroke. The effects only last for a few minutes and are usually fully resolved within 24 hours.
F.A.S.T.
The main signs and symptoms of a TIA can be identified by remembering the word F.A.S.T., which stands for Face-Arms-Speech-Time.
Face the face may have fallen on one side, the person may be unable to smile, or their mouth or eye may have dropped Arms the person may not be able to raise both their arms and keep them there due to weakness or numbness in their arms Speech the person may have slurred speech Time if any of these signs or symptoms are present, it is time to dial 999 immediately
If the above signs and symptoms last longer than 24 hours, it is regarded as a full stroke. It is important that a person who has a TIA is checked and treated as soon as possible to minimise the risk of having a further TIA or a full stroke. With treatment, the risk of a further TIA or full stroke can be greatly reduced. Read more about how to recognise the signs and symptoms of a TIA.
A TIA can also occur as a result of a blood clot that forms in a blood vessel and blocks the blood supply to your brain. In rare cases, a TIA can be caused by a small amount of bleeding in the brain, known as a haemorrhage. Read more about the causes of TIA.
Diagnosing a TIA
As TIAs are often over quickly, you may not have any symptoms by the time you see a healthcare professional. You will be asked in detail about the symptoms you experienced during the TIA. For example, how long they lasted and how they affected you. This will help rule out other conditions. If a TIA is suspected, you should be referred within seven days of the TIA to a specialist for tests. Read more about diagnosing a TIA.
Treating a TIA
Following a TIA, you will need treatment to help prevent another TIA or a full stroke. Your treatment will depend on your individual circumstances, such as your age and medical history.Your healthcare team will discuss the treatment options with you, and tell you about possible benefits and risks. You may be given medication or asked to make changes to your lifestyle (see the prevention advice below). In some cases, surgery may be needed. Read more about how TIAs are treated.
Preventing a TIA
TIAs often occur without warning. If you have a TIA, it is a sign another one may follow and further TIAs can have more serious effects or develop into a full, life-threatening stroke. Regardless of whether or not you have had a TIA or stroke in the past, there are a number of ways you can lower your risk of having either in the future. These include:
maintaining a healthy weight eating healthily taking regular exercise
Read more about how lifestyle factors can help prevent a TIA.
Transient Ischemic Attack (TIA) Overview
The control centers of the brain The brain controls how our body functions, how we think, how we see, how we talk, and how we move. The signals to and from the brain are transmitted through the spinal cord to the rest of the body. The right side of the brain controls the left side of the body, and the left side of the brain controls the right side of the body. This includes movement and sensation. Speech centers usually are located in the Broca's area on the left side of the brain. Vision is controlled by the back of the brain in the occipital lobes. The carotid arteries provide the majority of the blood supply to these parts of the brain (known as the anterior circulation). Balance and coordination are controlled by the cerebellum, or the base of the brain, and its blood supply comes from the vertebral arteries located in the bony canals in the back of the vertebral column (referred to as the posterior circulation). When an area of the brain loses its blood supply it stops working and the part of the body it controls also stops working. This is what happens with a stroke or CVA (cerebrovascular accident). When the brain loses blood supply, it tries to restore blood flow. If blood supply is restored, function may return to the affected brain cells, permitting return of function to the affected body part. This is what happens with a TIA (transient ischemic attack). Some may consider this a mini-stroke, however, in reality, it is a stroke that has resolved or has improved functionality in the affected body part. By definition, a TIA resolves within 24 hours, but most TIA symptoms resolve within a few minutes. TIAs are often warning signs of a future stroke. The risk of a stroke increases dramatically in the days after a transient ischemic attack, and the TIA may offer an opportunity to find a cause or minimize the risk to prevent the permanent neurologic damage that results because of a stroke.
Blood clots can float downstream from the heart and get caught in a tiny blood vessel (embolus). Atrial fibrillation (A fib) is the most common reason for an embolus. In atrial fibrillation, the upper chambers of the heart jiggle and don't beat in a coordinated fashion. This allows blood to become stagnant and form small clots. These clots can embolize to any organ in the body, but the brain is a common target. Debris can occlude the blood vessels and stop blood flow. This debris often breaks off from carotid arteries that are narrowed by the atherosclerotic disease process described above. Blood vessels can leak and cause bleeding within the brain tissue. An intracerebral hemorrhage (intra=within + cerebral= of the brain + hemorrhage=bleeding) is often caused by high blood pressure which can cause small blood vessel walls to become thin and weak.
If there is concern that there may be clots coming from the heart or debris coming from heart valves, then an echocardiogram (ultrasound examination of the heart) may be indicated to help with the diagnosis as to the origin of the TIA.
Risk Factor
Yes or No
Age > 60
Yes No
1 Point 0 Points
Yes No
1 Point 0 Points
Unilateral (one sided) weakness with or without speech impairment OR Speech disturbance without weakness
2 Points
1 Point
Duration
Diabetes
Yes No
1 Point 0 Points
ABCD2 Scoring
ABCD Score
2
0-3
1%
ABCD2 Scoring
ABCD Score
2
4-5
4%
6-7
8%
ABCD Scoring
ABCD Score 7 Day Stroke Risk
0-4
0.4%
12%
6 or greater
31%
Medical Treatment
Treatment of TIA is aimed at preventing a future stroke. Minimizing risk factors is a priority, including optimizing blood pressure,cholesterol and lipid levels, and controlling diabetes. Aspirin is the drug of choice to prevent future TIAs or stroke. Aspirin makes platelets less sticky and prevents clot formation. If the TIA occurs when the patient is already taking aspirin, then alternative anti-platelet drugs like clopidogrel bisulfate(Plavix) or aspirin-dipyridamole ER(Aggrenox) may be indicated. If the carotid ultrasound shows major narrowing of the artery (stenosis), referral to a vascular surgeon may be necessary to unclog the artery with a procedure known as carotid endarterectomy.
Next Steps
TIAs cannot be ignored since they are warning signs for a potential future stroke. Ten percent of people with TIAs will have a stroke within three months. The purpose of accessing medical care is to help minimize risk factors to help decrease that 10% risk. Published studies in 2007 suggest that if blood pressure is tightly controlled, cholesterol levels are reduced with medication, and smoking cessation is begun, the risk of future stroke can be reduced to 2%.