Doctor's Notes on Transient Ischemic Attack
Transient ischemic attack (also termed a TIA or mini-stroke) is when an area of the brain has its blood supply interrupted and produce symptoms of a stroke that usually resolve quickly within a few minutes up to 24 hours as the blood supply interruption resolves. A TIA is also a warning sign of possible future strokes. The signs and symptoms of a TIA are virtually identical to those of a stroke except that the symptoms resolve. Signs and symptoms of a TIA are
- neurological deficits that can affect the ability to move or feel on one side of the body,
- speech and vision can be affected, and the person may experience confusion,
- difficulty seeing words and have the inability to follow commands,
- they also may develop dizziness, loss of balance, and/or coordination,
- difficulty walking,
- a sudden fall (drop attack), and
- a sudden loss of vision in one eye that results spontaneously (amaurosis fugax).
The cause of transient ischemic attacks is an intermittent decrease or stoppage of blood and oxygen to brain cells. This blockage can originate from blood clot formation, debris from occluded blood vessels outside of the brain (for example, a carotid artery with plaque deposits), and by pressure on the brain's blood vessels caused by some bleeding within the brain. For TIAs, these causes resolve spontaneously within minutes to 24 hours.
What Are the Treatments for a Transient Ischemic Attack (TIA or Mini-Stroke)?
Initial treatment of a TIA is the same treatment used to treat strokes. Recognition of a stroke is the first step in treatment of this common medical emergency. Symptoms usually happen quickly and may include the following:
- Sudden numbness and/or weakness on one side of the body
- Slurred speech or inability to talk
- Double vision or blurry vision in one eye
- Sudden loss of balance; falling down
- If symptoms resolve quickly (minutes to 24 hours), the diagnosis is usually a TIA, pending a CT or MRI exam and stroke team evaluation.
Call 911 immediately (transport patient to a hospital that has an on-call stroke team if possible). The next treatments need to be done in a hospital by medical caregivers. They will determine if the patient has a stroke (ischemic or hemorrhagic) or a transient ischemic attack (TIA). An emergency CT brain scan is usually done almost immediately on arrival in the ER. The stroke team (neurologist, and others) will quickly decide what treatments should be done depending on their findings. For a TIA, the treatments depend on the underlying cause:
- Severe arterial narrowing in the brain: aspirin, clopidogrel
- Atrial fibrillation: warfarin, apixaban
- Carotid artery plaques: surgery to open the carotid artery
- Carotid endarterectomy (plaque removal)
- Carotid angioplasty and stent placement (flattens out the plaque and the stent keep the plaque flat and the artery open)
Your doctors can design a treatment plan to address your individual condition.
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