Transient ischemic attack (TIA)
Overview
A transient ischemic attack (TIA) is a temporary period of symptoms similar to those of a stroke. A TIA usually lasts only a few minutes and doesn't cause permanent damage.Often called a ministroke, a TIA may be a warning.
About 1 in 3 people who has a TIA will eventually have a stroke, with about half occurring within a year after the TIA.
A TIA can serve as both a warning of a future stroke and an opportunity to prevent it.
Symptoms
Transient ischemic attacks usually last a few minutes. Most signs and symptoms disappear within an hour, though rarely symptoms may last up to 24 hours. The signs and symptoms of a TIA resemble those found early in a stroke and may include sudden onset of:- Weakness, numbness or paralysis in the face, arm or leg, typically on one side of the body
- Slurred or garbled speech or difficulty understanding others
- Blindness in one or both eyes or double vision
- Vertigo or loss of balance or coordination
When to see a doctor
Since TIAs most often occur hours or days before a stroke, seeking medical attention immediately following a possible TIA is essential. Seek immediate medical attention if you suspect you've had a TIA. Prompt evaluation and identification of potentially treatable conditions may help you prevent a stroke.Causes
A TIA has the same origins as that of an ischemic stroke, the most common type of stroke. In an ischemic stroke, a 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 underlying cause of a TIA often is a buildup of cholesterol-containing fatty deposits called plaques (atherosclerosis) in an artery or one of its branches that supplies oxygen and nutrients to the brain.
Plaques can decrease the blood flow through an artery or lead to the development of a clot. A blood clot moving to an artery that supplies the brain from another part of the body, most commonly from the heart, also may cause a TIA.
Risk factors
Some risk factors for a TIA and stroke can't be changed. Others you can control.Risk factors you can't change
You can't change the following risk factors for a TIA and stroke. But knowing you're at risk can motivate you to change your lifestyle to reduce other risks.- Family history. Your risk may be greater if one of your family members has had a TIA or a stroke.
- Age. Your risk increases as you get older, especially after age 55.
- Sex. Men have a slightly higher risk of a TIA and a stroke. But as women age, their risk of a stroke goes up.
- Prior transient ischemic attack. If you've had one or more TIAs, you're much more likely to have a stroke.
- Sickle cell disease. Stroke is a frequent complication of sickle cell disease. Another name for this inherited disorder is sickle cell anemia. Sickle-shaped blood cells carry less oxygen and also tend to get stuck in artery walls, hampering blood flow to the brain. However, with proper treatment of sickle cell disease, you can lower your risk of a stroke.
Risk factors you can control
You can control or treat a number of factors — including certain health conditions and lifestyle choices — that increase your risk of a stroke. Having one or more of these risk factors doesn't mean you'll have a stroke, but your risk increases if you have two or more of them.Health conditions
- High blood pressure. The risk of a stroke begins to increase at blood pressure readings higher than 140/90 millimeters of mercury (mm Hg). Your health care provider will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.
- High cholesterol. Eating less cholesterol and fat, especially saturated fat and trans fat, may reduce the plaques in your arteries. If you can't control your cholesterol through dietary changes alone, your provider may prescribe a statin or another type of cholesterol-lowering medication.
- Cardiovascular disease. This includes heart failure, a heart defect, a heart infection or a heart rhythm that isn't typical.
- Carotid artery disease. In this condition, the blood vessels in the neck that lead to the brain become clogged.
- Peripheral artery disease (PAD). PAD causes the blood vessels that carry blood to the arms and legs to become clogged.
- Diabetes. Diabetes increases the severity of atherosclerosis — narrowing of the arteries due to accumulation of fatty deposits — and the speed with which it develops.
- High levels of homocysteine. Elevated levels of this amino acid in the blood can cause the arteries to thicken and scar, which makes them more susceptible to clots.
- Excess weight. Obesity, especially carrying extra weight in the abdominal area, increases stroke risk in both men and women.
- COVID-19. There is evidence that SARS-CoV-2, the virus that causes COVID-19, may raise the risk of stroke.
Lifestyle choices
- Cigarette smoking. Quit smoking to reduce your risk of a TIA and a stroke. Smoking increases your risk of blood clots, raises your blood pressure and contributes to the development of cholesterol-containing fatty deposits in the arteries (atherosclerosis).
- Physical inactivity. Engaging in 30 minutes of moderate-intensity exercise most days helps reduce risk.
- Poor nutrition. Reducing your intake of fat and salt decreases your risk of a TIA and a stroke.
- Heavy drinking. If you drink alcohol, limit yourself to no more than two drinks daily if you're a man and one drink daily if you're a woman.
- Use of illicit drugs. Avoid cocaine and other illicit drugs.
Prevention
Knowing your risk factors and living healthfully are the best things you can do to prevent a TIA. Included in a healthy lifestyle are regular medical checkups. Also:- Don't smoke. Stopping smoking reduces your risk of a TIA or a stroke.
- Limit cholesterol and fat. Cutting back on cholesterol and fat, especially saturated fat and trans fat, in your diet may reduce buildup of plaques in the arteries.
- Eat plenty of fruits and vegetables. These foods contain nutrients such as potassium, folate and antioxidants, which may protect against a TIA or a stroke.
- Limit sodium. If you have high blood pressure, avoiding salty foods and not adding salt to food may reduce your blood pressure. Avoiding salt may not prevent hypertension, but excess sodium may increase blood pressure in people who are sensitive to sodium.
- Exercise regularly. If you have high blood pressure, regular exercise is one of the few ways you can lower your blood pressure without drugs.
- Limit alcohol intake. Drink alcohol in moderation, if at all. The recommended limit is no more than one drink daily for women and two a day for men.
- Maintain a healthy weight. Being overweight contributes to other risk factors, such as high blood pressure, cardiovascular disease and diabetes. Losing weight with diet and exercise may lower your blood pressure and improve your cholesterol levels.
- Don't use illicit drugs. Drugs such as cocaine are associated with an increased risk of a TIA or a stroke.
- Control diabetes. You can manage diabetes and high blood pressure with diet, exercise, weight control and, when necessary, medication.
