A sudden loss of strength or altered sensation, dizziness, or loss of balance or coordination can be symptoms of a transient ischemic attack, and may serve as a warning and an opportunity for early treatment.
A transient ischemic attack (TIA) is a subtype of stroke, as it produces similar symptoms but usually lasts only a few minutes and does not cause permanent damage.
What is a transient ischemic attack (TIA)?
A transient ischemia or transient ischemic attack (TIA) occurs when there is an interruption or reduction in blood flow to part of the brain, often caused by a blood clot.
After a short time, blood flow resumes and the symptoms disappear. In a stroke, the blood circulation remains blocked, and the brain suffers permanent damage. Some people refer to a TIA as a mini-stroke because the symptoms are similar to those of a stroke but do not last long.
A transient ischemia is a warning: it means you are likely to have a stroke in the future. If you think you are having a TIA, call 911 or other emergency services immediately. Early treatment can help prevent a stroke. If you think you’ve had a TIA but the symptoms have gone away, you should still call your doctor right away.
What are the symptoms?
The signs and symptoms of a transient ischemic attack vary depending on the affected cerebral vascular territory.
For example, a transient ischemia affecting the anterior cerebral circulation, which includes the brain blood vessels originating from the carotid arteries, may present clinically as hemiparesis, hemianesthesia, contralateral motor or sensory deficits in the face or limbs, amaurosis fugax (temporary monocular blindness), the appearance of a descending “shadow” in the field of vision, or a temporary episode of blurred vision.
The signs and symptoms of a transient ischemia affecting the posterior cerebral circulation, which includes the brain blood vessels originating from the vertebral and basilar arteries, may include dysarthria, dysphagia, diplopia, bilateral blindness, unilateral or bilateral motor and sensory weakness, tetraplegia, ataxia, vertigo, and a sensation of dizziness.
What causes a transient ischemic attack (TIA)?
A transient ischemic attack is a predictor of stroke, given the risk factors involved in its pathophysiology, most of which are highly prevalent in primary healthcare settings, such as high blood pressure, smoking, alcohol consumption, and diabetes mellitus. Therefore, it is important to take them into account.
In addition to this, it is essential to recognize which symptoms, as reported by the patient in a context of spontaneously resolved neurological symptoms, may be related to the course of a transient ischemic attack, and what risk they may present of leading to a subsequent stroke.
What tests should be done after experiencing a transient ischemic attack?
Your doctor will run tests to examine your heart and blood vessels. You may need:
- Tests that provide images of the brain and blood vessels, such as a computed tomography (CT) scan, a magnetic resonance imaging (MRI) exam, a magnetic resonance angiography (MRA), or an angiography.
A test that uses sound to examine blood flow (Doppler ultrasound).- An echocardiogram to check the shape of your heart and the blood flow.
- An electrocardiogram (ECG) to measure your heart rhythm.
- Blood tests, such as a complete blood count and a fasting blood test, to detect issues that may be causing your symptoms.
Your doctor will also examine you to see if there is anything else that may have caused the symptoms.
How is a transient ischemic attack treated?
The treatment of a transient ischemic attack is based on the pathophysiological mechanism responsible for the event. Attention should be given to systemic alterations that may trigger or worsen the neurological condition, and these should be corrected promptly.
Hypotension, hypo- or hyperglycemia, hypoxemia and hypercapnia, as well as electrolyte imbalances, must be corrected.
Your doctor will start with medications to help prevent a stroke. You may need to take several medications.
If tests show that the blood vessels (carotid arteries) in the neck are too narrow, you may need a procedure to open them. This can help prevent blood clots from blocking the flow of blood to the brain.
How can another transient ischemic attack or a stroke be prevented?
The best thing you can do to prevent a transient ischemic attack is to know your risk factors and maintain a healthy lifestyle. A healthy lifestyle includes having regular medical checkups, as well as the following:
- Do not smoke. Quitting smoking reduces the risk of having a transient ischemic attack or a stroke.
- Limit cholesterol and fat intake. Reducing the amounts of cholesterol and fats, especially saturated fats and trans fats, in your diet can decrease plaque buildup in the arteries.
- Healthy eating with fruits and vegetables. These foods contain nutrients such as potassium, folate, and antioxidants that may offer protection against a transient ischemic attack or a stroke.
- Limit sodium intake. If you have high blood pressure, avoiding salty foods and not adding salt to meals can help lower your blood pressure. Avoiding salt may not prevent hypertension, but excess sodium can increase blood pressure in people who are sensitive to it.
- Exercise regularly. If you have high blood pressure, regular physical activity is one of the few ways you can lower it without medication.
- Limit alcohol consumption. If you drink alcohol, do so in moderation. The recommended limit is a maximum of one drink per day for women and two per 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 through diet and exercise can lower blood pressure and improve cholesterol levels.
- Do not use illicit drugs. Illicit drugs such as cocaine are associated with a higher risk of transient ischemic attacks or strokes.
- Control diabetes. You can manage diabetes and high blood pressure through diet, exercise, weight control, and, if necessary, medication.
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