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Transient Ischemic Attack

(TIA; Mini-Stroke)

Definition

Transient ischemic attack (TIA) is a brief problem of the brain. It is due to a shortage of blood and oxygen. It is sometimes called a mini-stroke.
TIA is a serious problem. It is a warning of a future stroke .
Blood Supply to the Brain
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Causes

TIA happens when blood flow to the brain is too low. This can be from a narrowing or a blockage.
Narrowing may happen with:
  • A build up of plaque, called atherosclerosis
  • Vasculitis—inflammation of the blood vessels
A blockage may happen with:
  • A piece of a blood clot or plaque that has broken off from another site
  • Blood and blood-clotting problems, such as:
    • Severe anemia —too few red blood cells
    • Polycythemia —too many red blood cells
    • Hyperviscosity—thickening of the blood
  • Endocarditis —an infection of the lining of the heart

Risk Factors

TIAs are more common in older adults.
Some things that may raise the risk of TIA are:

Symptoms

TIA symptoms happen quickly. The problems a person has depends on the part of the brain that is affected. Symptoms are like those of a stroke.
Problems may be:
  • Loss of strength
  • Clumsiness
  • Problems speaking
  • Problems seeing, such as blindness in one eye
  • Numbness or tingling
  • A feeling of spinning when you are still

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.
Tests that may be done include:

Treatment

A TIA raises the risk of a stroke. The risk is highest in the first week after a TIA. The goal of treatment is to lower the risk of future stroke. This can be done with:
  • Lifestyle changes, such as not smoking, eating a healthful diet, exercising, and limiting alcohol
  • Manage health problems, such as diabetes, high blood pressure , or high cholesterol
  • Medicines to prevent blood clots or to slow clotting
  • Surgery to treat a blockage in the artery in the neck

Prevention

TIA cannot always be prevented. To lower the risk:
  • Manage high blood pressure.
  • Avoid using tobacco.
  • Limit alcohol.
  • Maintain a healthy weight through diet and exercise.

RESOURCES

American Heart Association
http://www.heart.org
National Stroke Association
http://www.stroke.org

CANADIAN RESOURCES

Canadian Society for Vascular Surgery
http://canadianvascular.ca
Heart and Stroke Foundation
http://www.heartandstroke.com

References

Duca A, Jagoda A. Transient Ischemic Attacks: Advances in Diagnosis and Management in the Emergency Department. Emerg Med Clin North Am. 2016 Nov;34(4):811-835.
Transient ischemic attack information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Transient-Ischemic-Attack-Information-Page. Accessed October 5, 2020.
Risk factors for stroke or transient ischemic attack. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/risk-factors-for-stroke-or-transient-ischemic-attack . Accessed October 5, 2020.
Sangha RS, Caprio FZ, et al. Quality of life in patients with TIA and minor ischemic strokes. Neurology. 2015;85(22):1957-63.
Transient ischemic attack (TIA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/transient-ischemic-attack-tia . Accessed October 5, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2020
  • Update Date: 10/05/2020
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