Description

A transient ischemic attack (TIA) is a short period of symptoms similar to those of a stroke. It is caused by a brief blockage of blood flow to the brain. A TIA usually lasts only a few minutes and does not cause long-term damage.

However, a TIA can be a warning. Approximately 1 out of every 3 people who have a TIA will eventually have a stroke, with about half occurring within a year after the TIA .

Often called a mini stroke, a TIA can serve as a warning of a stroke in the future and an opportunity to prevent it.

Symptoms

Transient ischemic attacks usually last a couple of minutes. Most of the symptoms disappear within an hour. Rarely, symptoms may last for up to 24 hours. The symptoms of a TIA are similar to those found early in a stroke. The symptoms occur suddenly and can include:

  • Weakness, numbness or paralysis in the face, arm, or leg, usually on one side of the body.
  • Difficulty speaking or difficulty understanding others.
  • Blindness in one or both eyes, or double vision.
  • Dizziness or loss of balance or coordination.

You can have more of a TIA . Its symptoms can be similar or different, depending on the area of the brain that is involved.

When to see a doctor

If you think that you are having or have had a transient ischemic attack, seek medical attention immediately. TIAs occur with greater frequency in hours or days before a stroke. Be evaluated quickly means that health professionals may find the possible treatable conditions. The treatment of these conditions may help prevent a stroke.

Causes

The cause of a transient ischemic attack is similar to the cause of an ischemic stroke, which is the most common type of stroke. In an ischemic stroke, a blood clot blocks the blood supply to part of the brain. In a TIA , unlike a stroke, the blockage is brief, and there is no permanent damage.

The crash that occurs during a TIA is often the result of an accumulation of cholesterol-containing fatty deposits called plaques in the arteries. This is known as atherosclerosis. The accumulation may also occur in an artery branches that supply oxygen and nutrients to the brain.

The plaques can decrease the flow of blood through an artery or lead to the development of a clot. A blood clot that moves to another part of the body, like the heart, an artery that supplies blood to the brain can also cause a TIA .

Risk factors

Some risk factors of transient ischemic attack and stroke can not be changed. Others you can control.

Risk factors you cannot change

You can't change these factors of risk of a TIA and stroke. But knowing that you have these risks may motivate you to change the risk factors that you can control.

  • The history of the family. The risk may be greater if one of the members of your family have had a TIA or a stroke.
  • Age. Your risk increases with age, especially after the age of 55 years.
  • Sex. Men have a slightly higher risk of a TIA and a stroke. But as women get older, your risk of a stroke increases.
  • Before a transient ischemic attack. If you have had one or more Tias , you are much more likely to have a stroke.
  • The sickle cell disease. Stroke is a frequent complication of sickle cell disease, also known as sickle cell anemia. Sickle-shaped blood cells carry less oxygen and also tend to get stuck in the walls of the arteries, affecting the blood flow to the brain. But with the proper treatment of the disease of sickle cell, you can reduce your risk of a stroke.

Risk factors you can control

You can control or treat a number of risk factors for a TIA and a stroke, including certain health conditions, and lifestyle choices. Have one or more of these risk factors does not mean that you are going to have a stroke, but the risk increases if you have two or more of them.

Health conditions

  • The high blood pressure. The risk of a stroke begins to increase in the blood pressure readings of 140/90 millimeters of mercury (mm Hg) and higher. Your health care professional can help you decide on a goal blood pressure based on your age and other factors, such as if you have diabetes.
  • High cholesterol. Eat less cholesterol and fat, especially saturated fat and trans fat, may reduce the plaques in the arteries. If you can't control your cholesterol through changes in diet alone, the doctor may prescribe a statin or other cholesterol-lowering medication.
  • Cardiovascular disease. This includes heart failure, a heart defect, an infection in the heart or a heart rhythm condition.
  • Disease of the carotid artery. In this condition, the blood vessels in the neck that lead to the brain is obstructed.
  • Peripheral arterial disease (PAD). PAD causes the blood vessels that carry blood to the arms and legs to become clogged.
  • Diabetes. Diabetes accelerates and aggravates the narrowing of the arteries due to the buildup of fatty deposits, known as atherosclerosis.
  • High levels of homocysteine. The elevated levels of this amino acid in the blood can cause the arteries to thicken and scar. This makes them more susceptible to the formation of blood clots.
  • The excess of weight. Obesity, especially excess weight in the stomach, increases the risk of stroke.
  • COVID-19. There is evidence that the virus that causes COVID-19 can increase the risk of stroke.

Lifestyle options

  • Smoking cigarettes. Smoking increases the risk of blood clots, increases blood pressure, and plays an important role in the development of atherosclerosis. But quitting smoking lowers the risk of having a TIA or a stroke.
  • Physical inactivity. Participate in 30 minutes of moderate-intensity exercise most days of the week helps reduce the risk.
  • Poor nutrition. Eat less fat and salt decreases the risk of a TIA and a stroke.
  • Excessive consumption of alcohol. If you drink alcohol, limit yourself to a maximum of one drink per day for women and up to two drinks per day for men.
  • Use of illicit drugs. Avoid cocaine and other illicit drugs.

Prevention

Know the risk factors and healthy lifestyle are the best things you can do to prevent a transient ischemic attack. A healthy lifestyle includes regular medical checkups. Also:

  • Do not smoke. Quitting smoking reduces the risk of a TIA or a stroke.
  • Limit the amount of cholesterol and fat. Reduce the cholesterol and fat, especially saturated fat and trans fat in your diet can reduce the accumulation of plaque in the arteries.
  • Eat lots of fruits and vegetables. These foods contain nutrients such as potassium, folic acid and antioxidants, which can protect against a TIA or a stroke.
  • Limit the amount of sodium. If you have high blood pressure, avoid salty foods and not adding salt to foods. These habits can help to reduce your blood pressure. Limit the salt may not prevent the high blood pressure, but too much sodium can increase blood pressure in some people.
  • Exercise regularly. If you have high blood pressure, regular exercise is one of the few ways that you can reduce your blood pressure without medication.
  • Limit the consumption of alcohol. Drink alcohol only in moderation, if at all. The recommended limit is no more than one drink per day for women and two drinks per day for men.
  • Maintain a healthy weight. Excess weight contributes to other risk factors, like high blood pressure, cardiovascular disease, and diabetes. Lose weight with diet and exercise can lower your blood pressure and improve your cholesterol levels.
  • Do not use illicit drugs. Illicit drugs such as cocaine is associated with an increased risk of a TIA or a stroke.
  • The Control of diabetes. You can control diabetes and high blood pressure with diet, exercise, weight control and, when needed, medicine.

Diagnosis

A rapid assessment of the symptoms is vital in diagnosing the cause of a transient ischemic attack. It also helps your health professional to determine the best treatment. To locate the cause of your TIA and to assess the risk of a stroke, your health care professional may depend on the following:

  • Physical examination and pruebas.Su health care professional performs a physical exam and a neurological exam. The evidence of his vision, eye movements, speech and language, strength, reflexes, and sensory system are included. Your health care professional may use a stethoscope to listen to the carotid artery in the neck. During this test, the whooshing sound called a bruit may mean that you have atherosclerosis. Or to your health care provider may use an ophthalmoscope. This instrument seeks to cholesterol or fragments of platelet fragments called emboli in the small blood vessels of the retina in the back of the eye. You can also check the risk factors of a stroke. These include high blood pressure, high cholesterol levels, diabetes, and, sometimes, high levels of the amino acid homocysteine.
  • Carotid ultrasonography. If your healthcare provider suspects that a narrowing of the carotid artery in the neck can be the cause of your TIA , you may need an ultrasound of the carotid artery. A wandlike device called a transducer sends high-frequency sound waves in the neck. The sound waves pass through the tissues and to create images on a screen. The images can show narrowing or clotting of the blood in the carotid arteries.
  • The computed tomography (CT) or computed tomography angiography (CTA) scans. The ct scan of the head to the use of X-ray beams to create a 3D image. This allows your healthcare provider to look at the brain or in the arteries in the neck and brain. The angio-ct can involve an injection of contrast material in the blood vessels. Unlike a carotid ultrasound, angio-ct, which you can look at the blood vessels in the neck and the head.
  • Magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA). These tests use a strong magnetic field to create a 3D view of the brain. MRA uses technology similar to that of magnetic resonance imaging to look at the arteries in the neck and brain. But a MRA may include an injection of a contrast material in the blood vessels.
  • Echocardiography.This test may be done to know if a matter of the heart caused fragments in the blood that led to a crash. A traditional echocardiography is called a transthoracic echocardiogram (TTE). ATTEinvolves move an instrument called a transducer on the chest to look at the heart. The transducer emits sound waves that bounce off the different parts of the heart, creating a picture of ultrasound. Or you may need another type of echocardiogram called a transesophageal echocardiogram (TEE). A flexible probe with a transducer placed in the tube that connects the mouth and stomach, known as the esophagus. Because the esophagus is directly behind the heart, aTEEcan to create more clear, detailed, ultrasound images. This allows a better view of some things, such as blood clots, which can't be seen clearly in a traditional echocardiography examination.
  • The arteriography.This procedure is used by some people to get a view of arteries in the brain that are not usually seen in an x-ray. A radiologist inserts a thin, flexible tube called a catheter through a small incision, usually in the groin area. The catheter is guided through the major arteries in the carotid or vertebral artery in the neck. Then, a dye is injected through the catheter. The contrast allows the arteries is seen in the x-ray images.

Physical examination and tests. Your health care professional performs a physical exam and a neurological exam. The evidence of his vision, eye movements, speech and language, strength, reflexes, and sensory system are included.

Your health care professional may use a stethoscope to listen to the carotid artery in the neck. During this test, the whooshing sound called a bruit may mean that you have atherosclerosis. Or to your health care provider may use an ophthalmoscope. This instrument seeks to cholesterol or fragments of platelet fragments called emboli in the small blood vessels of the retina in the back of the eye.

You can also check the risk factors of a stroke. These include high blood pressure, high cholesterol levels, diabetes, and, sometimes, high levels of the amino acid homocysteine.

Echocardiography. This test may be done to know if a matter of the heart caused fragments in the blood that led to a crash. A traditional echocardiography is called a transthoracic echocardiogram (TTE). A TTE involves the displacement of an instrument called a transducer on the chest to look at the heart. The transducer emits sound waves that bounce off the different parts of the heart, creating a picture of ultrasound.

Or you may need another type of echocardiogram called a transesophageal echocardiogram (TEE). A flexible probe with a transducer placed in the tube that connects the mouth and stomach, known as the esophagus. Because the esophagus is directly behind the heart, a t-SHIRT you can create more clear, detailed, ultrasound images. This allows a better view of some things, such as blood clots, which can't be seen clearly in a traditional echocardiography examination.

The arteriography. This procedure is used by some people to get a view of arteries in the brain that are not usually seen in an x-ray. A radiologist inserts a thin, flexible tube called a catheter through a small incision, usually in the groin area.

The catheter is guided through the major arteries in the carotid or vertebral artery in the neck. Then, a dye is injected through the catheter. The contrast allows the arteries is seen in the x-ray images.

Treatment

Once your health care provider learns that the cause of the transient ischemic attack, the goal of treatment is to correct the problem and prevent a stroke. You may need medications to prevent blood clots. Or you may need surgery.

Medications

There are several medications that can reduce the risk of stroke after a TIA . Your healthcare provider recommended a medication based on what's caused the TIA , where it is located, its type and severity of the obstruction was. Your health care professional may prescribe:

  • Anti-platelet drugs.These drugs cause a movement of blood cells called platelets less likely to stick together. Sticky platelets begin to form clots when the blood vessels injured. Clotting proteins in the blood plasma are also involved in the process. Aspirin is the most commonly used anti-platelet medicine. Aspirin is also the least expensive and the treatment with the least amount of potential side effects. An alternative to aspirin is an anti-platelet drug clopidogrel (Plavix). Aspirin and clopidogrel may be prescribed together for about a month after theTIA. Research shows that taking these two medicines together in certain situations it reduces the risk of stroke in the future rather than taking aspirin alone. Sometimes both drugs are taken together for a long period of time. This may be recommended when the cause of theTIAis a narrowing of a blood vessel in the head. When there is a serious block of a main artery, the medicine cilostazol can be prescribed with aspirin or clopidogrel. On the other hand, the health care provider may prescribe ticagrelor (Brilinta) and aspirin for 30 days to decrease the risk of recurrent stroke. Your healthcare provider may also prescribe a combination of low-dose aspirin and the anti-platelet drug dipyridamole to reduce the clotting of the blood. The way in which dipyridamole works is slightly different from the aspirin.
  • Anticoagulants. These drugs include heparin and warfarin (Jantoven). Reduce the risk of blood clots, which affect the coagulation of the proteins of the system in place of the platelet function. Heparin is used during a short period of time and is rarely used in the management of Tias .

Anti-platelet drugs. These drugs cause a movement of blood cells called platelets less likely to stick together. Sticky platelets begin to form clots when the blood vessels injured. Clotting proteins in the blood plasma are also involved in the process.

Aspirin is the most commonly used anti-platelet medicine. Aspirin is also the least expensive and the treatment with the least amount of potential side effects. An alternative to aspirin is an anti-platelet drug clopidogrel (Plavix).

Aspirin and clopidogrel may be prescribed together for about a month after the TIA . Research shows that taking these two medicines together in certain situations it reduces the risk of stroke in the future rather than taking aspirin alone.

Sometimes both drugs are taken together for a long period of time. This may be recommended when the cause of the TIA is a narrowing of a blood vessel in the head.

When there is a serious block of a main artery, the medicine cilostazol can be prescribed with aspirin or clopidogrel.

On the other hand, the health care provider may prescribe ticagrelor (Brilinta) and aspirin for 30 days to decrease the risk of recurrent stroke.

Your healthcare provider may also prescribe a combination of low-dose aspirin and the anti-platelet drug dipyridamole to reduce the clotting of the blood. The way in which dipyridamole works is slightly different from the aspirin.

These drugs require careful monitoring. If you have atrial fibrillation, your healthcare provider may prescribe a direct oral anticoagulant such as apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Savaysa) or dabigatran (Pradaxa), which may be safer than warfarin due to a lower risk of bleeding.

Surgery

If the carotid artery in the neck is very low, your health care professional may suggest a surgery called carotid endarterectomy (end-ahr-tur-EK-tuh-me). This preventive surgery erases carotid arteries of fatty deposits before another TIA or stroke can occur. An incision is made to open the artery, the plates are removed, and the artery is closed.

Angioplasty

Some people need a procedure called carotid angioplasty and stent placement. This procedure involves the use of a device in the form of a balloon to open a blocked artery. Then, a small wire tube called a stent is placed in the artery to keep it open.

Preparing for your appointment

A transient ischemic attack, often diagnosed in an emergency situation. But if you are concerned about your risk of having a stroke, you can plan to talk with your healthcare provider at your next appointment.

What you can do

If you want to discuss the risk of a blow with your health care professional, write, and be prepared to discuss:

  • The risk factors for stroke, such as family history of strokes.
  • Your medical history, including a list of all medications, as well as any vitamins or supplements that you are taking.
  • Key personal information,such as lifestyle habits, and the main factors of stress.
  • If you think you've had aTIA and what are the symptoms that you have experienced.
  • The questions that you may have.

What to expect from your doctor

Your health care professional may recommend that you have several tests to check your risk factors. Will give you instructions on how to prepare for tests, such as fasting before having your blood drawn to check levels of cholesterol and blood sugar levels.

Symptoms and treatment of Transient ischemic attack (TIA)