Mini strokes, also known as TIAs or transient ischemic attacks, can cause serious side effects. But they often go away on their own.
TIA symptoms disappear as quickly as they come, so CAT and MRI scans can’t detect them. So doctors use other tests to diagnose a TIA. These may include an echocardiogram to look for blood clots or a communication between the two sides of the heart called a PFO.
Symptoms
Sometimes, we’re tempted to ignore strange symptoms like a sudden weakness or numbness, especially if they’re short-lived. But those fleeting episodes might signal something serious, including a transient ischemic attack (TIA, or mini stroke). A TIA happens when a blood clot blocks the flow of oxygen-rich blood to part of the brain, leading to temporary trouble with thinking and movement. It’s usually caused by a heart problem but can be the result of other factors, such as high blood pressure or diabetes. Unlike a stroke, there’s no pain involved with a TIA.
Symptoms can include a numb or weak feeling in the face or arm (usually on one side), difficulty walking or balance, a headache, blurry or double vision, and slurred speech. If you notice these symptoms, ask the person to raise both arms. Can they do it? Does one droop? Also, listen to the person’s voice. Is it slurred? The timing of these symptoms is crucial, because a stroke typically occurs within 24 hours of the first sign.
In addition to a neurological exam, doctors will probably run blood tests to measure blood-clotting factors and check your electrocardiogram for signs of a heart rhythm disorder, such as atrial fibrillation. They may also order a computed tomography (CT) or magnetic resonance imaging (MRI) scan of the brain to see what part of the brain was affected and check for evidence of damage from lack of blood flow.
If a TIA is determined to be the cause of the stroke, medication can help prevent another clot-related stroke in the future. But the best medicine is preventive: Eat well, exercise, lose weight, and don’t smoke to lower your risk of a stroke. After a stroke, treatment can focus on regaining your physical and mental skills. A doctor may suggest speech therapy, occupational or physical therapy, and help with daily tasks such as getting dressed and cooking, bathing, using the toilet, and moving around your home. Other therapies may help you with emotional or psychological problems, such as depression or anxiety. Getting support from family and friends can also be helpful.
Diagnosis
A transient ischemic attack (TIA) occurs when the blood supply to part of the brain is cut off temporarily, usually by a blood clot that has formed elsewhere in the body and then travelled to the blood vessels supplying the brain. The blockage usually resolves as the clot dissolves or is dislodged. TIA causes similar symptoms to a stroke but is not permanent, and there is no lasting damage. TIAs can be early warning signs of a full-blown stroke, and about 1 in 3 people who have one go on to experience a full stroke within months.
Symptoms of a TIA appear suddenly and are very similar to the symptoms of a stroke. They can include a drooping face, weakness of the arm on one side of the body, and difficulty or inability to speak, often with slurred speech. Unlike a stroke, which can last hours, TIA symptoms are brief, usually about 30 minutes, and then disappear. If you or someone else experiences these symptoms, call 999 immediately.
Your doctor will ask you questions and carry out a physical examination. Depending on your symptoms, you may be given a MRI scan or CT scan of the brain to help diagnose a TIA or stroke. These tests can detect any area of the brain affected by the TIA or stroke and show how much damage there has been. They can also identify the type of TIA or stroke and look for factors that increase the risk of future ministrokes and full strokes, such as high blood pressure, atrial fibrillation, diabetes, smoking, and a family history of stroke.
If you or a loved one has had a TIA, your doctor will prescribe medications to reduce the chances of a future stroke and may advise lifestyle changes. Medications can include drugs to reduce blood pressure, and they can be used in combination with other treatments to reduce the chance of another stroke. Treatments for a TIA may include surgery to remove blood clots from the brain. If you have a severe clot in a large blood vessel, your doctor may give you a clot-dissolving medication called tPA, but this only works if it is given within three hours of the start of symptoms.
Treatment
If you have a mini stroke, it’s important to seek medical attention as soon as possible. It’s also a good idea to be tested for the main risk factors for a stroke, such as high blood pressure, diabetes, atrial fibrillation and blocked arteries. These factors can be treated and reduced with medication or lifestyle changes.
If the doctor can’t find out what caused your TIA, they may give you medications that prevent blood clots or other health problems that increase your risk of a stroke. This could include aspirin, clopidogrel (Plavix), ticagrelor (Brilinta) or a combination pill called Aggrenox. Taking your medicine as prescribed is one of the best ways to cut your risk.
Most TIA symptoms go away within an hour and don’t cause any permanent damage to brain tissue. However, they are a warning that a full-blown stroke could happen in the future. Around a third of people who have a TIA will eventually have a full-blown stroke.
Whether you have a TIA or a full-blown stroke, a healthcare professional will treat you to prevent future problems, reduce disability and help you get back as much of your previous functioning as possible through rehabilitation. Your healthcare team might also recommend a dietary plan to reduce your risk of further strokes and other diseases, such as heart disease, diabetes and high cholesterol.
It’s important to get plenty of sleep and exercise to keep your weight, blood pressure and cholesterol in a healthy range. Eating a balanced diet is also important. Limiting sugar and salt and eating lots of fruit, vegetables and fibre can lower your risk of stroke. A regular routine for sleeping and getting to bed at a reasonable time can also help.
If you have a blocked artery in your neck, you might be offered surgery to clear the blockage with a procedure known as carotid angioplasty and stent placement. During this, your healthcare professional will insert a small wire tube, called a catheter, into an artery in your neck, then inject a dye so they can see the clogged artery on X-ray images.
Prevention
A stroke is a devastating health event, and it’s often a warning sign of future problems. That’s why doctors work so hard to find the cause of TIA and help people improve their health so they can prevent a full-blown stroke in the future.
A TIA is a temporary interruption of blood flow to the brain caused by a blood clot. It’s also called a “mini-stroke.” Most of the symptoms are similar to those of a stroke, but they don’t last as long and can be reversed.
The signs of a TIA usually disappear within a few minutes, but it’s important to get medical attention immediately. Even if the symptoms don’t last, a TIA raises your risk of having a full stroke in the next 90 days — and half of all strokes that happen after a TIA occur within the first two weeks afterward. The good news is that most strokes are preventable.
Taking control of lifestyle factors can significantly reduce a person’s chance of having a stroke or TIA. The most common risk factor is high blood pressure, which doesn’t always have symptoms, so it’s important to get your blood pressure checked regularly.
Other health conditions can increase a person’s risk of having a stroke, including heart disease, diabetes, and sleep disorders such as obstructive sleep apnea (OSA). It’s also important to maintain a healthy weight, quit smoking, and exercise regularly.
There are also medications that can help reduce the risk of having another stroke or TIA, such as antithrombotic drugs. These can be taken by mouth or intravenously. It’s important to follow your doctor’s instructions, and ask questions if you don’t understand something.
If you have had a TIA, it’s a good idea to tell loved ones about your plans to reduce your risk of stroke, in case they can support you or encourage you to stay on track with your goals. It’s also helpful to talk to a therapist or join a support group if you have anxiety or depression, which can also be a risk factor for stroke.