Transient Ischemic Attacks (TIAs) – Cause, Symptoms and Treatment Options

A sudden, temporary lack of blood flow to the brain leads to Transient Ischemic Attacks (TIAs) also known as mini-strokes. Unlike a Hemorrhagic stroke and Ischemic Stroke, a TIA does not kill brain cells or cause permanent disability.

TIA symptoms, similar to an ischemic stroke, resolves within 24 hours, however, most of them usually last for just a few minutes. These warning signs include numbness on one side of the body, dizziness or balance imbalance, confusion, trouble in talking or understanding, vision problems and severe headache. TIAs, like two other kinds of strokes, may have large, obvious neurologic defects like paralysis.

Individuals over 60 and with high blood pressure, high cholesterol, diabetes, heart disease, obesity issues, smoking habit and family history of strokes are at higher risk of getting a TIA.  Sometimes, a mini stroke can be a warning sign of an Ischemic Stroke. 10% of people with TIAs will have a stroke within three months. Studies imply that if blood pressure, cholesterol levels are controlled with medication, the risk of future stroke can be reduced to only 2%.

TIA Diagnosis and Treatment

If the symptoms persist and a stroke situation exists, the patient needs to be examined, though blood tests and several other tests need to be performed to ensure that the bleeding into the brain is not the cause of the symptoms. A full neurologic exam should be carried out for identifying any weakness or numbness, walk and coordination issue, vision problems and any impairments related to hearing, speech and language comprehension. Other tests that may be considered include Electrocardiogram (for checking irregular heart rhythms), CT scan of the head (for checking bleeding in the brain) and Carotid Ultrasound (for checking narrowing of the blood vessels in the anterior part of the neck.

Once the doctor has determined the cause of the TIA, the goal of the treatment is to correct the abnormality and prevent a stroke. Depending on the cause of the mini stroke, your doctor may prescribe medication to reduce blood clotting or may suggest surgery.

Medication

Doctors use several medications to decrease the likelihood of a stroke, depending on the location, cause and severity of TIA. Some practitioners may prescribe Aggrenox, a combination of Aspirin and Dipyridamole. Medications for hypertension and medications for cholesterol can also be prescribed alongside Antiplatelet medicines to optimize blood pressure, cholesterol and lipid levels.

Surgical Option(s)

If the carotid ultrasound figures out major narrowing of the artery (stenosis), a vascular surgeon may need to unclog the artery using Carotid Endarterectomy. The preventive procedure involves removing part of the lining of the damaged carotid artery and any fatty deposits that have accumulated therein. The procedure is avoided for people with partial blockage because of the risk of stroke during the surgery.

In certain cases, a surgery called Carotid Angioplasty, also known as Stenting, is recommended. The procedure involves inserting and inflating a tiny balloon to open a clogged artery and placing a small wire tube (stent) into the artery to decrease the chance of it narrowing again.  

Stroke Prevention Post-TIA

Minimizing stroke risk factors is a lifelong effort. It is important for a TIA patient to stick with his treatment plan and follow-up medical appointments. Apart from taking medicine, such as blood thinners, one can lower the risk of having a stroke by investing in a healthy lifestyle. This includes limiting smoking and drinking, eating a healthy diet and exercising to control high blood pressure and cholesterol.

Having a well-balanced diet, with plenty of fruit and vegetables, whole grains, fish, poultry, and very lean meat is important.  Junk foods and foods with saturated and trans fats should be avoided. Reducing salt (sodium) intake is also helpful for Individuals who are prone to high blood pressure. Exercising for at least 150 minutes throughout a week and losing weight to normal levels is recommended to decrease the risk of having a stroke. Reserving at least 7 hours for sound quality, continuous sleep every day is also necessary.