What is a transient ischemic attack?
A transient ischemic attack (TIA) is a sudden and brief reduction in blood flow to the brain. It is considered an early warning sign of a stroke: Approximately one in three strokes is preceded by a transient ischemic attack, and about a quarter of the strokes that occur each year are TIAs. Unlike a “true” cerebral infarction, the stroke-like symptoms of a TIA resolve within 24 hours or even a few minutes.
Colloquially, TIA is often called a “mini-stroke.”
What are the symptoms of a TIA?
A transient ischemic attack causes short-term neurological symptoms like those that occur during a stroke. What kind they are depends mainly on the brain region affected by the transient lack of blood flow. The most important symptoms include:
- Sudden, unilateral loss of vision (amaurosis fugax).
- Half-sided visual field loss (hemianopsia) – the visual field is that area of the environment that you see without moving your eyes or head
- Seeing double images
- Loss of sensation or incomplete paralysis of one side of the body (hemianesthesia or hemiparesis)
- Speech disorder (aphasia), speech disorder (dysarthria)
- Dizziness, ear noises
- Fainting
What is the treatment of a TIA?
A transient ischemic attack is the harbinger of an impending stroke. Therefore, it must be taken seriously! Even if visual disturbances, numbness or paralysis soon disappear, you should see a doctor immediately, if possible in a hospital with a stroke unit.
There, specialized doctors will examine you closely to find out the reason for the temporary reduction in blood flow. With appropriate treatment, a new transient ischemic attack and a “real” stroke can be avoided in the best case!
Doctors usually treat a TIA with platelet aggregation inhibitors. These are so-called “blood thinners” such as acetylsalicylic acid (ASA) and clopidogrel, which prevent blood platelets (thrombocytes) from clumping together into a clot and thus blocking a vessel again. Stroke patients receive these “thrombus inhibitors” either as monotherapy or in combination.
In addition, blood pressure-lowering drugs such as ACE inhibitors or diuretics serve to prevent further transient ischemic attacks and thus also a cerebral infarction.
How does a TIA occur?
Sometimes the tiny clots come from the heart area, for example in atrial fibrillation. This is the most common form of heart rhythm disorder. Blood clots easily form in the heart. They travel directly with the blood to the brain, where they trigger a transient ischemic attack.
What is the course of a TIA?
A transient ischemic attack is characterized by fleeting symptoms that usually do not initially lead to serious complications. However, although the neurological disturbances disappear within a short time, these “mild” strokes carry a high risk of recurrence, especially if the TIA is untreated. This means that they usually recur – often within the first few days after a TIA. In numerous cases, a transient ischemic attack is also followed by an acute stroke with the corresponding complications.
You can read more about the complications of a stroke in the article Stroke – Consequences.