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Transient Ischemic Attack


What is a transient ischemic attack (TIA)?

A TIA is also called a mini-stroke. A TIA happens when blood cannot flow to part of your brain. A TIA lasts a short time, and the effects are gone in less than 24 hours. A TIA does not cause lasting damage, but it may be a warning that you are about to have an ischemic stroke. An ischemic stroke happens when blood flow to the brain is suddenly blocked, usually by a blood clot.

What are the signs and symptoms of a TIA?

Any of the following may come and go:

  • Numbness, tingling, weakness, or paralysis
  • Trouble walking, swallowing, talking, or understanding language
  • Blurry or double vision

How is a TIA diagnosed?

Your healthcare provider will ask about your signs and symptoms and when they started. He will ask about any medical conditions you have. The following tests will help him diagnose a TIA:

  • A carotid ultrasound shows the blood flow in your carotid arteries. The carotid arteries are blood vessels in your neck that carry blood to your brain. A carotid ultrasound checks for narrow or blocked carotid arteries.
  • CT or MRI pictures may show blood flow blockage in your brain. You may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is a TIA treated?

  • Medicines:
    • Antiplatelets prevent blood clots from forming. Aspirin is an antiplatelet. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
    • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
      • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
      • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
      • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
      • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
      • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
        • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
        • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
    • Other medicines may be needed to treat diabetes, depression, high cholesterol, or blood pressure problems. You may also need medicine to decrease the pressure in your brain, reduce pain, or prevent seizures.
  • Surgery may be needed to open a blocked artery (blood vessel). Blocked carotid arteries cause poor blood flow to the brain or heart.

What increases my risk for a TIA?

  • Being a man or African American
  • Age 55 years or older
  • Birth control pills or hormone replacement medicine for women
  • A family history of stroke, or a low birthweight
  • High blood pressure, blood vessel disease, or sickle cell anemia that is not being treated
  • Atrial fibrillation, diabetes, or another heart condition

What lifestyle changes can decrease my risk for a TIA or stroke?

  • Manage health conditions. High blood pressure, diabetes, and high cholesterol all increase your risk for a TIA or stroke. Take your medicine as directed. Follow your healthcare provider's instructions to check your blood pressure and blood sugar levels. Keep a record of your blood pressure and blood sugar readings. Bring the record with you to follow-up visits with your healthcare provider.

  • Eat a variety of healthy foods. The foods you eat can help prevent or manage high blood pressure, high cholesterol, and diabetes. Eat foods that are low in fat, cholesterol, salt, and sugar. Eat at least 5 servings of fruits and vegetables each day. Include food that are high in potassium, such as potatoes and bananas.
  • Reach or stay at a healthy weight. Weight loss can decrease your blood pressure and your risk for stroke. Ask your healthcare provider how much you should weigh and how to lose weight safely. Ask how often you should exercise and which exercises to do.
  • Do not smoke cigarettes or use illegal drugs. Smoking and drugs increase your risk for a stroke. Nicotine and other chemicals in cigarettes and cigars can also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products. Ask your healthcare provider for information if you need help quitting.

How can I tell if someone is having a stroke?

Know the F.A.S.T. test to recognize the signs of a stroke:

  • F = Face: Ask the person to smile. Drooping on 1 side of the mouth or face is a sign of a stroke.
  • A = Arms: Ask the person to raise both arms. One arm that slowly comes back down or cannot be raised is a sign of a stroke.
  • S = Speech: Ask the person to repeat a simple sentence that you say first. Speech that is slurred or sounds strange is a sign of a stroke.
  • T = Time: Call 911 if you see any of these signs. This is an emergency.

Call 911 for any of the following:

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss

When should I seek immediate care?

  • You have double vision or vision loss.
  • You have a severe headache or feel dizzy.
  • You are bleeding from your rectum or nose.

When should I contact my healthcare provider or neurologist?

  • Your blood pressure is higher or lower than you were told it should be.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.