TRANSIENT ISCHEMIC ATTACK

General Information

DEFINITION--A temporary decrease in the blood supply to part of the brain. The affected part of the brain is temporarily unable to function normally.

BODY PARTS INVOLVED--Blood vessels to the brain and the part of the brain supplied by the affected blood vessels.

SEX OR AGE MOST AFFECTED--Adults over age 40.

SIGNS & SYMPTOMS--

The following symptoms are brief, lasting from several minutes to a few hours.

• Loss of muscle function on one side of the body.
• Headache.
• Dizziness.
• Tingling in the arms and legs.
• Numbness.
• Vision disturbance or temporary blindness in one eye.
• Confusion.
• Faintness without loss of consciousness.
• Slurred speech or inability to speak.

CAUSES--TIA's are caused by a partial blockage in a small artery in the brain or a larger artery (usually the carotid artery in the neck) that supplies blood to brain arteries. The blockage is often caused by a small clot from heart or blood vessel that breaks away and is carried into the brain. This temporarily decreases blood flow to an area of the brain and causes strokelike symptoms.

RISK INCREASES WITH

• Smoking.
• Personal or family medical history of high blood pressure and atherosclerosis.
• Diabetes.
• Heart attack.
• Cardiac disease.
• Polycythemia.

HOW TO PREVENT

• Exercise at least 3 times a week to maintain good cardiovascular fitness.
• Follow recommendations under Diet.
• Don't smoke.
• Have your blood pressure checked regularly. If it is high, consult your doctor for treatment to reduce it.
• Daily aspirin may help, ask your doctor.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies.
• ECG (See Glossary); x-rays of the heart, lungs and blood flow (angiography) and ultrasound (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Treatment may include medications, control of risk factors (diabetes, hypertension, cardiac disease, etc.), and lifestyle changes.
• Surgery (endarterectomy) to remove plaques (fatty deposits) from carotid arteries in the neck.

POSSIBLE COMPLICATIONS--Stroke. Without treatment, about 50% of persons who have TIA's have strokes within 5 years.

PROBABLE OUTCOME--

• Transient ischemic attacks are often signals of an impending stroke. They should be treated to reduce the risk of future stroke, which may cause serious and permanent brain damage.
• TIA's are likely to recur. A person may have several attacks daily or only 2 or 3 over several years. The symptoms of each attack may be similar or quite different from others. In some patients symptoms appear repeatedly without leaving permanent damage.

How To Treat

GENERAL MEASURES--

• Stop smoking. Get counseling, join support group or find other methods to help you quit.
• Follow your doctor's instructions. Compliance with your medical treatment plan is essential for the best outcome.

MEDICATION--Your doctor may prescribe:

• Anticoagulants, such as warfarin, to decrease the formation of blood clots.
• Daily aspirin. Aspirin can decrease blood-clotting enough to reduce the likelihood of TIA's developing into stroke. The aspirin seems more effective in men than women.

ACTIVITY--If you have frequent TIA's, don't drive, work in high places or operate machinery.

DIET--Eat a normal, well-balanced diet that is low in salt and fat, especially saturated fat. (See both diets in Appendix.)

Call Your Doctor If

• You have your first symptoms of a TIA.
• Symptoms of a TIA recur after diagnosis and persist longer than 2 hours.