TIAs – a red flag warning of possible stroke

TIAs – a red flag warning of possible stroke

TIAs also known as transient ischemic attack, is when blood flow to part of the brain stops for a short period of time.  When a TIA happens, it can mimic symptoms of a stroke and in fact are often called mini-strokes because the symptoms appear briefly and last less than 24 hours before they disappear.  However, experts warn not to view TIAs as just a blip in your brain function.  Instead, TIAs should serve as a “warning stroke” requiring medical attention. 

While TIAs usually do not cause permanent brain damage with no lingering symptoms, they are a warning you that a full-blown stroke could happen in the future and should not be ignored.  Up to 40 percent of people who have a TIA will go on to have a stroke with nearly half of all strokes occurring within the first few days after a TIA. 

Causes of TIAs

There are three things that generally cause most TIAs:

1.     Reduced blood flow of a major artery such as the carotid artery carrying blood to the brain.

2.     A blood clot occurring in a different part of the body that has broken off and has traveled to the brain blocking a blood vessel within it.

3.     A narrowing of the smaller blood vessels in the brain that block blood flow temporarily caused by plaque build-up.

As we age, our risk of having a TIA increases.  Individuals of African American descent or those with a family history of stroke are also more at risk. 

Chronic health conditions also play a role in increasing the chance of a TIA – high blood pressure, heart disease, obstructive sleep apnea, diabetes, high cholesterol, atrial fibrillation, carotid artery or peripheral artery disease and sickle cell disease.  Additional risk factors include excess weight gain, lack of physical activity, smoking, and heavy drinking.

Symptoms of a TIA

Symptoms of a TIA are very similar to a stroke which can include weakness on one side of the body, vision problems, and slurred speech.  Other symptoms people may experience with a TIA include:

·      Difficulty walking or problems with coordination

·      Muscle weakness

·      Feeling faint, lightheaded, or having vertigo

·      Muscle weakness or numbness in the face

·      Difficulty swallowing

·      Mental confusion

Any of the above symptoms a person is experiencing, requires prompt emergency medical attention.  Remember the acronym FAST:

·      Face drooping

·      Arm weakness

·      Speech difficulty

·      Time to call for emergency medical help

Being evaluated for a TIA

Even though the symptoms of a TIA are short-lived, a person should still seek medical help as they are at a high risk for a stroke to follow soon.  The quicker a person can be evaluated, the less damage there will be to the brain.  For every hour of delay, the brain loses as many neurons as it does over 3.6 years of normal aging.

A doctor or a first responder will check blood pressure and ask questions of your age and how long the symptoms have lasted.  The evaluation will also include asking you to blink, squeeze their hands, checks for weakness in the arms and legs, and your ability to speak.

Several brain-imaging tests will most likely be done such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) to check for any permanent brain damage.  An electrocardiogram (ECG) will test electrical activity of the heart looking for atrial fibrillation and possibly a chest x-ray or ultrasound of the heart (echocardiography) may be conducted.

Once it has been determined if it was a stroke, treatment for it includes clot-busting medication or in certain cases, devises that can pull the clot out.

Preventing future TIAs

The goal of TIA management is to prevent a future stroke.  Once it can be figure out what was the cause of a TIA, can it then be recommended on what to do to prevent additional TIAs or a major stroke.

Medications or any therapy required will depend on the cause of the TIA.  Lifestyle changes such as improving dietary habits, losing weight, increasing physical activity, limiting alcohol intake, and quitting smoking can all be used management treatments to help reduce the chance of another TIA.

If it is discovered that the TIA was caused by a blockage in the carotid artery in the neck that supplies blood to the brain, surgery may be required to open the artery to prevent a stroke.  This procedure is known as endarterectomy and stenting.

The best solution is to take charge of your health today to reduce the incidence of a TIA to begin with.