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Five things you should know about transient ischemic attacks (TIA)

Often referred to as a “mini-stroke,” a Transient Ischemic Attack (TIA) may actually be a warning sign for a future stroke. We asked Neurologist Chris Streib, MD, to tell us more.
What is a Transient Ischemic Attack (TIA)? For many people, a TIA is a warning sign that a person is at higher risk of a major stroke. We asked University of Minnesota Health Neurologist Chris Streib, MD, to explain.
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A stroke is a debilitating and life-changing event. It often strikes without warning and can leave victims with permanent brain damage.

Prior to a stroke, some victims may experience a Transient Ischemic Attack, or TIA, which is a temporary blockage of blood to the brain similar to a stroke. Also known as “mini-strokes,” TIAs leave no lasting brain damage or residual symptoms. However, they serve as a warning sign that a person is at higher risk of a major stroke and should seek immedite medical attention.

We asked University of Minnesota Health Neurologist Chris Streib, MD, to tell us five things we should know about TIAs and how they can help prevent a full stroke.

A TIA looks and feels like a stroke, but leaves no permanent damage.

Like a stroke, a TIA occurs when a blockage in a blood vessel stops the flow of blood to part of the brain. Unlike a stroke, TIA symptoms do not persist and resolve within 24 hours—and often much faster. Most importantly, a TIA doesn’t leave any permanent brain damage or cause lasting neurologic problems. However, a TIA does involve many of the same signs and symptoms as a stroke.

A person experiencing a TIA might feel weakness or numbness on one side of the body, have slurred speech and have trouble seeing or talking. They may also be confused. They may experience a combination of these symptoms at the same time.

“The real takeaway? A TIA is an event that comes and goes without causing any permanent brain damage, but it is a warning sign,” Streib said.

Don’t wait. Seek medical attention immediately.

Many people experiencing a TIA don’t seek medical attention right away—often because the symptoms may seem minor or because the person believes they will go away.

That’s dangerous, Streib said, because while symptoms are present, a TIA and a stroke are indistinguishable from one another. In both cases, it is critical that the victim receives rapid medical attention. The symptoms may appear benign at first, but they can worsen later. For a stroke, quick medical care can minimize brain damage and reduce the risk of lasting impairments.

“The initial symptoms of stroke and TIA are indistinguishable. If you suspect that you or someone that you know is having a stroke or TIA, go to the hospital immediately, even if the symptoms are minor,” Streib said. “You cannot always accurately predict if a person will get better or worse and you want all treatment options readily available.”

It’s a warning sign, not a “mini-stroke.”

A TIA is often referred to as a “mini-stroke,” but this name is misleading, according to Streib. TIAs may not be minor—symptoms can be quite severe, even though they leave no permanent damage to the brain. Also, it’s important to recognize a TIA as a warning sign, because it often precedes a full stroke.

A person who experiences a TIA may have as much as a 10 percent risk of having a full stroke in the next seven days, Streib said. If they seek the proper care, patients can reduce that risk significantly.

“In some ways, people who have a TIA are actually very fortunate. It’s a warning that they are at high risk of a stroke that could cause permanent deficits,” Streib said. “They have a chance to make immediate lifestyle and medication change to reduce their risk of an actual stroke.”

Learn more about our treatment and services for stroke.

Get adequate follow-up care immediately.

To significantly reduce their risk of having a stroke, a person who has experienced a TIA must seek the proper follow-up care immediately after the episode.

Streib recommends that all patients visit an emergency department during or immediately after a TIA to receive neuro-imaging of their brain and vascular imaging of their blood vessels. These scans can inform patients and providers of the cause of their TIA and their immediate stroke risk. Scans also help them decide upon a treatment plan.

Seeking care at an emergency department is preferable to the outpatient setting, Streib said, because it can take much longer in the outpatient setting to order tests and interpret results. For some, that might be too late to prevent a subsequent stroke. Additionally, small hemorrhagic strokes can sometimes mimic a TIA, and those require a very different treatment approach.

Identify the cause and make lifestyle changes.

After a patient has received immediate medical attention following a TIA, Streib recommends working with a specialist to establish a long-term health plan to reduce the ongoing risk of a stroke—especially if the cause of the TIA remains unknown. Stroke specialists may use innovative treatment options and long-term testing methods.

“Patients need to see an expert,” Streib said. “Stroke prevention is based upon treating the patient’s specific underlying risk factors. Some of these risk factors are not readily apparent and may require diagnostic testing that takes months or longer. A stroke physician is in the best position to identify the cause and help a patient take action to prevent a stroke.”

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