A Transient Ischaemic Attack is effectively a mini-stroke, may be a precursor to a full stroke and is a useful indicator of potential dangers. Robert Mair reports.

In this article

  • Transient ischaemic attack
  • Symptoms
  • Risk factors
  • Treatment

Transient ischaemic attack

A transient ischaemic attack (also known as a TIA or mini-stroke) is a short-term condition with similar symptoms to a full-stroke. But the symptoms will disappear within 24 hours and the person will make a full recovery.

TIA and strokes occur when a blood vessel carrying oxygenated blood to a part of the brain becomes blocked. However, in TIAs the blockage is only temporary and may be caused by:

  • A blood clot (or debris found in blood) getting stuck in a small blood vessel
  • Stenosis, or narrowing of the arteries
  • Bleeding in the brain

If the blockage is permanent, it is likely to produce a full stroke. TIAs therefore can provide an early warning, and if fully examined and treated can help prevent any future problems.

Between 30,000 and 50,000 people will have a TIA in England every year.  3,000 – 5,000 of those will go on to have a full stroke within four weeks.

Unfortunately strokes often cause at least some form of permanent disability. 9% of male and 13% of female UK deaths are caused by strokes.

Symptoms

Although severe symptoms for a TIA will clear within 30 minutes, people might feel the effects all day. The main symptoms include:

  • Slurred speech
  • Numbness down one side of the body
  • Confusion
  • Dizziness
  • Difficulty understanding the meaning of words or the names of objects
  • Memory problems
  • Problems with swallowing
  • Temporary loss of vision
  • Temporary loss of consciousness

To test whether someone has had a TIA, the Stroke Association recommends using the Face Arm Speech Test (FAST). To do a FAST test:

  1. Check the persons Face to see if their eyes or mouth have drooped and if they are able to smile.
  2. Check if they can raise both Arms
  3. Check if they can understand what you are saying and if they can Speak clearly
  4. Time to dial 999

These symptoms will not ease if the person is experiencing a full stroke, but will ease over the course of a day if it is a TIA.

Risk factors

There are a number of different risk factors which can contribute to a TIA. These include:

  • Age. Older people are at far greater risk than younger people
  • Family history. If a close family member has suffered a stroke, the risk increases
  • Gender. Men are more at risk than women
  • Ethnicity. Asian and people of African and Caribbean descent are at greater risk
  • Prior medical conditions. Diseases such as diabetes, phlebitis (inflammation of blood vessel walls, usually in the legs) sickle cell anaemia and leukaemia can all increase the chances of having a TIA
  • High blood pressure. About a quarter of all cases of TIAs are caused by high blood pressure
  • Smoking. Smoking doubles your chances of having a TIA

Treatment

Medical treatment should be sought as quickly as possible following a TIA; further TIAs could follow – or even a full stroke. Doctors will attempt to find the underlying cause of the stroke and treat it accordingly, with the intention of preventing any further attacks.

The different symptoms experienced will indicate which part of the brain was affected, and the doctor will provide a number of scans to confirm this, including ultrasounds, CT and MRI scans.

Once the cause of the TIA has been determined, a number of treatments may be advised. These include:

  • Aspirin. Aspirin thins the blood and prevents clots from forming. It is a popular treatment for TIAs, and even a small dose can be hugely beneficial in preventing further TIAs. Another drug, clopidogrel, may be prescribed when aspirin is not advisable.
  • Surgery. If the two main arteries to the brain become blocked, the doctor may recommend a carotid endarterectomy. This is a procedure in which the blockage is removed.
  • Lifestyle changes. Changes to diet (such as reducing salt intake and lowering cholesterol levels) can greatly reduce the chances of further TIAs or strokes, as can losing weight (if overweight), quitting smoking and doing regular exercise.

Regardless of the severity of the symptoms, treatment should be sought for all TIAs, due to the dangers posed by a full stroke.