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Transient ischaemic attack

What is a TIA or transient ischemic attack?
A TIA is a "warning stroke" or "mini-stroke" that produces stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke.

Most strokes aren't preceded by TIAs. However, of the people who've had one or more TIAs, more than a third will later have a stroke. In fact, a person who's had one or more TIAs is more likely to have a stroke than someone of the same age and sex who hasn't.

TIAs are important in predicting if a stroke will occur rather than when one will happen. They can occur days, weeks or even months before a major stroke. In about half the cases, the stroke occurs within one year of the TIA.

What causes a transient ischemic attack?
TIAs occur when a blood clot temporarily clogs an artery, and part of the brain doesn't get the blood it needs. The symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes. The average is about a minute. Unlike stroke, when a TIA is over, there's no injury to the brain.

What are the symptoms of a TIA?
It's very important to recognize the warning signs of a TIA or stroke. The usual TIA symptoms are the same as those of stroke, only temporary:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden, severe headache with no known cause

The short duration of these symptoms and lack of permanent brain injury is the main difference between TIA and stroke.

Risk factors you can't change?
You can't change the following risk factors for transient ischemic attack and stroke. But knowing you're at risk can motivate you to change your lifestyle to reduce other risks.

Family history. Your risk may be greater if one of your family members has had a TIA or a stroke.
Age. Your risk increases as you get older, especially after age 55.
Gender. Men have a slightly higher likelihood of TIA and stroke, but more than half of deaths from stroke occur in women.
Sickle cell disease. Also called sickle cell anemia, stroke is a frequent complication of this inherited disorder. Sickle-shaped blood cells carry less oxygen and also tend to get stuck in artery walls, hampering blood flow to the brain.
Race. Blacks are at greater risk of dying of a stroke, partly because of the higher prevalence of high blood pressure and diabetes among blacks.

Risk factors you can take steps to control You can control or treat a number of risk factors, including:

High blood pressure. Risk of stroke begins to increase at blood pressure readings higher than 115/75 millimeters of mercury (mm Hg). Your doctor will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.
Cardiovascular disease. This includes heart failure, a heart defect, a heart infection or an abnormal heart rhythm.
Carotid artery disease. The blood vessels in your neck that lead to your brain become clogged.
Peripheral artery disease (PAD). The blood vessels that carry blood to your arms and legs become clogged.
Cigarette smoking. Smoking increases your risk of blood clots, raises your blood pressure and contributes to the development of cholesterol-containing fatty deposits in your arteries (atherosclerosis).
Physical inactivity. Engaging in 30 minutes of moderate intensity exercise most days helps reduce risk.
Diabetes. Diabetes increases the severity of atherosclerosis — narrowing of the arteries due to accumulation of fatty deposits — and the speed with which it develops.
Poor nutrition. Eating too much fat and salt, in particular, increases your risk of TIA and stroke.
High cholesterol. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the plaques in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a statin or another type of cholesterol-lowering medication.
High levels of homocysteine. Elevated levels of this amino acid in your blood can cause your arteries to thicken and scar, which makes them more susceptible to clots.
Excess weight. A body mass index of 25 or higher and a waist circumference greater than 35 inches in women or 40 inches in men increase risk.
Heavy drinking. If you drink alcohol, limit yourself to no more than two drinks daily if you're a man and one drink daily if you're a woman.
Use of illicit drugs. Avoid cocaine and other drugs.
Use of birth control pills. If you use any hormone therapy, talk to your doctor about how the hormones may affect your risk of TIA and stroke.

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