Transient ischemic attacks (or TIAs, for short) have long been nicknamed ministrokes since they don’t cause permanent damage to the brain. But experts are increasingly pushing back on that moniker because a TIA reflects more than just a tiny blip in your brain function: It should be viewed as a “warning stroke” that warrants medical attention. “When these occur, they need to be taken very seriously — they’re an emergency because they may signal the person is at high risk of having a big stroke in the next few days or weeks,” says Dr. Larry Goldstein, chair of the department of neurology at the University of Kentucky in Lexington. In fact, about a third of people who have a TIA end up having a more severe stroke within a year, according to the American Stroke Association.
Like a stroke, a TIA is caused by an interruption in blood flow to the brain, usually from a blood clot or other blockage or from irregular beating of the heart. This can result in the abrupt onset of symptoms such as slurred speech, drooping of the face, weakness or numbness on one side of the body, blurred vision or vision loss, an unexplained severe headache, mental confusion, dizziness or balance and coordination problems. The difference is: With a TIA, the symptoms usually last five minutes or less and then disappear on their own. Even so, there can be lasting consequences: More than 35 percent of patients who had a TIA had some persistent cognitive impairment — particularly to working memory, attention or information processing speed — three months after the event, according to a study in the August 2014 issue of the journal Stroke.
[See: 10 Ways to Lower Your Risk of Stroke.]
Yet, while 35 percent of adults in the U.S. have had symptoms suggestive of a TIA, only 3 percent of them called 911 for help, according to a recent online survey of more than 2,000 people by the American Heart Association and American Stroke Association. That’s a mistake, experts say. If you have symptoms of a stroke or TIA, “don’t wait it out,” advises Dr. Dion F. Graybeal, medical director of stroke at the Baylor University Medical Center in Dallas. “Take these symptoms seriously and call 911.” If it’s a real stroke, every minute counts in terms of getting treatment and reducing the risk of permanent disability. And if it’s a TIA, “it’s an opportunity to intervene and hopefully stop a process or condition that could cause a stroke with disability in the future,” Graybeal says.
It’s better to be safe than sorry because if you have stroke-like symptoms, it’s difficult to tell immediately if you’re having a TIA or a full-blown stroke, says Dr. Nieca Goldberg, a cardiologist and medical director of the Joan H. Tisch Center for Women’s Health at the NYU Langone Medical Center in New York City. So it’s important to get to the hospital as soon as possible, There, you will most likely have a CT scan, a CT angiogram, an MRI or an MR angiogram of your brain and the blood vessels in your head to look for a blood clot and evidence of damage to the brain. If damage isn’t apparent and the symptoms have resolved, the episode will be deemed a TIA. But if there is evidence of damage to areas of the brain, the event will be diagnosed as a stroke, even if the symptoms have gone away, Goldstein says.
[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]
If it turns out that the TIA was due to narrowing of the carotid artery in your neck, a surgical or endovascular intervention may be recommended to remove the blockage or to place a stent in the artery to open it, Goldstein notes. If the TIA was caused by a blood clot, you may be put on a blood thinner or anti-clotting agent, says Dr. Mark Johnson, director of the stroke division at UT Southwestern Medical Center’s Peter O’Donnell Jr. Brain Institute in Dallas.
If a procedural intervention isn’t warranted, the goal is usually to prevent another TIA or a full-blown stroke from occurring in the future — by managing any risk factors you have. That means treating high blood pressure, diabetes, cholesterol abnormalities and atrial fibrillation with medications; stopping smoking; exercising daily; consuming a healthy diet such as the DASH or Mediterranean diet; maintaining a healthy weight; and limiting alcohol consumption.
[Read: 10 Commandments to Reduce Your Risk of Stroke.]
These preventive measures are important, “because TIAs and strokes are on a continuum,” Johnson says. “You don’t want to take a TIA lightly because it’s basically a warning for a stroke.” Heeding those warning signs and taking action to address underlying risk factors can actually prevent many full-blown strokes.
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TIAs: Don’t Call Them Ministrokes originally appeared on usnews.com
