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Home > Wellness > Health Library > Transient Ischemic Attack (TIA)
people call a transient ischemic attack (TIA) a mini-stroke, because the
symptoms are like those of a
stroke but don't last long. A TIA happens when blood
flow to part of the brain is blocked or reduced, often by a blood clot. After a
short time, blood flows again and the symptoms go away. With a stroke, the
blood flow stays blocked, and the brain has permanent damage.
TIA is a warning: it means you are likely to have a stroke in the future. If
you think you are having a TIA, call 911. Early treatment can help prevent a
stroke. If you think you have had a TIA but your symptoms have gone away, you
still need to call your doctor right away.
Symptoms of a TIA are the same as symptoms of a stroke. But symptoms of a TIA occur suddenly and don't last very long. Most of the time, they go away in 10 to 20 minutes. They may include:
clot is the most common cause of a TIA. Blood clots can be the result of
hardening of the arteries (atherosclerosis),
heart attack, or
abnormal heart rhythms. Brain cells are affected
within seconds of the blockage. That causes symptoms in the parts of the body
controlled by those cells. After the clot dissolves, blood flow returns, and the
symptoms go away.
Sometimes a TIA is caused by a sharp drop in
blood pressure that reduces blood flow to the brain. This is called a
"low-flow" TIA. It is not as common as other types.
Your doctor will
do tests to look at your heart and blood vessels. You may need:
Your doctor will also check to see if something else is
causing your symptoms.
Your doctor will start you on
medicines to help prevent a stroke. You may need to take several
If tests show that the blood vessels (carotid arteries) in your neck are too narrow, you may
need surgery to open them up (carotid endarterectomy). This can help prevent
blood clots that block blood flow to your brain.
Another type of surgery is
carotid artery stenting. During this surgery, the doctor puts a small tube
stent inside your carotid artery. This helps keep the
artery open. Carotid artery stenting is not as common as endarterectomy.
After you have had a
TIA, you are at risk for having another TIA or a stroke. But you can make some important
lifestyle changes that can reduce your risk of stroke and improve your overall
Learning about TIA:
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Health Tools help you make wise health decisions or take action to improve your health.
Blood clots that temporarily block
blood flow to the brain are the most common cause of
transient ischemic attacks (TIAs). Blood clots may
develop for a variety of reasons.
Also, an artery that is partially blocked with
plaque can reduce blood flow to the brain and cause
Rare causes of blood clots that can cause a TIA include:
TIA is a warning: It means you are likely to have a stroke in the future. If
you think you are having a TIA, call 911. Early treatment can help prevent a
stroke. If you think you had a TIA but your symptoms went away, you
still need to call your doctor right away.
transient ischemic attacks (TIAs) occur suddenly and
are always temporary. They usually go away in 10 to 20 minutes. TIA
symptoms are just like
stroke symptoms. They vary depending on which part of
the brain is affected. Common symptoms of TIA may include:
If symptoms last longer than an hour, it might be more likely that you have had a stroke.
A transient ischemic attack (TIA) is a
warning sign that a stroke may soon follow. Any symptoms of a TIA need to be
treated as an emergency.
A TIA also may signal an increased risk for a
Atherosclerosis, which is hardening of the arteries,
affects blood vessels throughout the body, including arteries that supply blood
to the heart and brain. Atherosclerosis that affects the blood vessels in the
heart (coronary arteries) may cause chest pain or a heart attack.
The risk factors (things that increase risk) for transient ischemic attack (TIA) and stroke include those you can treat or change and those you can't change.
Risk factors you can treat or change include:
Risk factors you cannot change
Call 911 or other emergency services immediately if you have:
Call your doctor immediately if you
Call your doctor today if you think you have had a TIA in
the past and have not yet talked with your doctor about your symptoms.
The following doctors can diagnose and treat a
transient ischemic attack (TIA):
Other specialists may be consulted if you need surgery
or have other health problems:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Immediate evaluation is recommended
if you have had or are having a
transient ischemic attack (TIA). The purpose of
evaluation is to:
If your TIA symptoms have completely disappeared, the
results of a
physical exam will be normal, and the diagnosis of a
TIA usually will be based on your
medical history and certain tests.
TIA is suspected, the doctor may want to do tests, such as a:
Further tests are often done to identify the cause of the TIA. If blockage of the
carotid arteries is suspected, you may have tests such
TIA symptoms may be due to blood clots caused by a heart
problem. If heart problems are suspected, you may have tests such as a:
You may have other blood tests, such as a
complete blood count (CBC), chemistry screen, and prothrombin time based on your age and
medical history. Your doctor will use these tests to look for other causes of
If you have symptoms of a
TIA, get medical help
If you had symptoms of a TIA but you feel better now, you still need to see a doctor right away. A TIA is a sign that a stroke may soon follow. Prompt medical
treatment may prevent a stroke.
If you've had a transient ischemic attack (TIA), you may need further testing and treatment after you've been checked by your doctor. If you have a high risk of stroke, you may have to stay in the hospital for treatment.
Your treatment for a TIA may include taking medicines to prevent a stroke or having surgery to reopen narrow arteries.
Medicines may include aspirin,
clopidogrel, dipyridamole with aspirin, or warfarin.
carotid arteries are significantly blocked, you may
need surgery to reopen the narrowed arteries (carotid endarterectomy).
Your treatment will also focus on
TIA or stroke. This may include:
You may also need to make lifestyle changes such
as quitting smoking, eating heart-healthy foods, and being more active.
You can help prevent a
transient ischemic attack (TIA) or stroke by controlling your
risk factors for
These are some of the common risk factors for stroke:
Home treatment is not appropriate for
transient ischemic attack (TIA). If you think you are
having a TIA, don't ignore the symptoms, and don't try to manage them at home.
If you had symptoms of a TIA but they went away, you still need to see a doctor right away.
Seek emergency medical care when symptoms first appear.
Prompt treatment may keep you from having a
You can care for yourself at home by adopting healthy habits that help you prevent another TIA or stroke. To learn more, see Prevention.
Your doctor will probably prescribe
several medicines after you have had a
transient ischemic attack (TIA). Medicines to prevent
blood clots are typically used, because blood clots can cause TIAs and
The types of medicines that
prevent clotting are:
Cholesterol-lowering and blood pressure-lowering medicines
are also used to prevent TIAs and strokes.
Antiplatelet medicines keep
platelets in the blood from sticking together.
Anticoagulants such as warfarin (for example, Coumadin) prevent blood clots from forming and keep existing blood clots from getting bigger. You may need to take this type of medicine after a TIA if you have atrial fibrillation or another condition that makes you more likely to have a stroke. For more information, see the topic Atrial Fibrillation.
Statins lower cholesterol and can greatly reduce the risk of stroke in people who have had a TIA. Statins even protect against stroke in people who don't have heart disease or high cholesterol.2
If you have high blood pressure, your doctor may want you to take medicines to lower it. Blood pressure medicines include:
If you have a serious blockage in the carotid arteries in your neck, you may need a carotid endarterectomy. During this surgery, a surgeon removes plaque buildup in the carotid arteries to reduce the risk of transient ischemic attack (TIA) or stroke.
The benefits and risks of this surgery must be carefully weighed, because the surgery itself may cause a stroke. Your need to have carotid endarterectomy depends on whether you have had a TIA or stroke and how much your carotid arteries have narrowed.
Carotid artery stenting (also called carotid angioplasty and stenting) is sometimes done as an alternative to surgery to prevent transient ischemic attack (TIA) or stroke. In this procedure, a doctor threads a thin tube called a catheter through an artery in the groin and up to the carotid artery in your neck. The doctor then uses a tiny balloon to enlarge the narrowed portion of the artery and places a stent to keep the artery open. Carotid artery stenting is not as common as carotid endarterectomy.
The National Institute of Neurological Disorders and
Stroke (NINDS), a part of the National Institutes of Health, is the leading
U.S. federal government agency supporting research on brain and nervous system
disorders. It provides the public with educational materials and information
about these disorders.
The Society of Interventional Radiology is a national organization of physicians, scientists, and health professionals dedicated to improving public health through disease management and minimally invasive, image-guided therapies.
Intervention radiology includes using X-rays, MRI, and other imaging to move a thin tube in the body, usually in an artery, to treat a disease. An example is angioplasty for heart disease. The Web site includes a section on patient information. This section gives information on therapies for various diseases and conditions. The Web site can also help you find a doctor.
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
HeartHub for Patients is a website from the American Heart
Association. It provides patient-focused information, tools, and resources
about heart diseases and stroke. The site helps you understand and manage your
health. It includes online tools that explain your risks and treatment options.
The site includes articles, the latest news in health and research, videos,
interactive tools, forums and community groups, and e-newsletters.
The website includes health centers that cover heart rhythm problems,
cardiac rehabilitation, caregivers, cholesterol, diabetes, heart attack, heart
failure, high blood pressure, peripheral artery disease, and stroke.
HeartHub for Patients also links to Heart360.org, another American Heart Association
website. Heart360 is a tool that helps you send and receive medical
information with your doctor. It also helps you monitor your health at home. It
gives you access to tools to manage and monitor high blood pressure, diabetes,
high cholesterol, physical activity, and nutrition.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
This association provides education, information,
referrals, and research on stroke. Information specific to survivors,
caregivers, family, women, and children is included.
Roger VL, et al. (2011). Heart disease and stroke statistics 2011 update: A report from the American Heart Association. Circulation, 123(4): e18–e209.
Furie KL, et al. (2011). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Published online October 21, 2010 (doi: 10.1161./STR.0b013e3181f7d043).
Other Works Consulted
Biller J, et al. (1998). Guidelines for carotid
endarterectomy: A statement for healthcare professionals from a special writing
group of the Stroke Council of the American Heart Association. Circulation, 97(5): 501–509.
Easton JD, et al. (2009). Definition and evaluation of transient ischemic attack: A scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. Stroke, 40(6): 2276–2293. Also available online: http://stroke.ahajournals.org/cgi/reprint/40/6/2276.
ESPRIT Study Group (2006). Aspirin plus dipyridamole
versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): A
randomized controlled trial. Lancet, 367(9523):
Rothwell PM, et al. (2007). Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): A prospective population-based sequential comparison. Lancet, 370(9596): 1432–1442.
Skinner JS, Cooper A (2009). Secondary prevention of ischaemic cardiac events, search date October 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458–2473.
U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
February 7, 2012
E. Gregory Thompson, MD - Internal Medicine & Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
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