TIA/Stroke


TIA (transient ischemic attack)

TIA (transient ischemic attack)

A stroke is an abrupt loss of brain function; this is often due to an interruption of blood flow to the brain (ischemic stroke). Blood vessels can become blocked either by clots forming in the vessel, or by clots or other debris floating downstream. Less commonly, strokes can be caused by the rupture of blood vessels in the brain (hemorrhagic stroke). When part of the brain is cut off from the blood supply, the brain will be damaged and its function will be impaired.

A transient ischemic attack (TIA) is often referred to as a “mini-stroke” or a “warning stroke”. A TIA, like an ischemic stroke, is caused by a clot that interrupts blood flow to the brain. However, the blockage that causes a TIA occurs for a relatively short period of time and resolves on its own (usually within 20 minutes). Unlike a stroke, a TIA usually does not result in any permanent brain damage. However, a TIA is a warning sign that an individual is likely to experience a full stroke in the near future, as approximately one third of those who experience a TIA will suffer from a stroke within a year.

Common risk factors for strokes include high blood pressure, diabetes, carotid or other artery disease, high blood cholesterol, and atrial fibrillation. Those with a family history of stroke are also at increased risk. Strokes and TIA occur at a higher rate in older populations, and are more common in men. Lifestyle factors such as smoking, poor diet, physical inactivity, and obesity also contribute to stroke or TIA.

TIA and stroke have the same symptoms. The effects vary depending on which region of the brain is affected and the extent of the damage. Strokes often cause impairments that affect mobility, sight, memory, verbal communication, ability to problem solve, and ability to read and write. Also common are numbness, weakness, confusion, and loss of coordination or balance. Some patients experience a sudden, severe headache with no known cause, and in many cases those experiencing a stroke or TIA will exhibit facial droop. Symptoms commonly occur on just one side of the body. The longer the brain goes without the supply of oxygen and nutrients provided by blood flow, the greater the risk of permanent brain damage.

Diagnosis will rely on a medical history and physical exam. If the symptoms of stroke have resolved, further testing is still recommended. Heart function may be assessed using an ECG and echocardiogram. Imaging of the brain and its blood vessels may be helpful in demonstrating the cause of symptoms. Imaging tests that may be used include CT scan, ultrasound, and MRI. Blood testing may also help diagnose stroke.

Treatment will depend on the cause of symptoms and whether they resolved on their own. If symptoms persist, medications to break up blood clots will be used immediately. Further treatment will focus on the underlying medical reason for the event and will attempt to prevent future stroke. Aspirin and blood thinners are commonly used in treatment. Other medications may be used to manage underlying conditions such as high blood pressure and high cholesterol. In addition, widening blood vessels in the neck may help to improve blood flow to the brain. Risk for a future stroke may be decreased through lifestyle changes such as maintaining a healthy weight, regular exercise, and decreasing exposure to cigarettes.

When symptoms occur, it is not possible to predict whether they will resolve on their own. There is a narrow window of time in which thrombolytic drugs will be effective in treating a stroke (within 4.5 hours). If you experience symptoms of stroke or TIA, call 911.

Sources:

“Transient Ischemic Attack.” Available on: http://www.webmd.com/stroke/tc/transient-ischemic-attack-tia-topic-overview

“Signs and Symptoms of Mini-Stroke.” Available on: http://www.healthline.com/health/stroke/signs-symptoms-tia-mini-stroke

“Transient Ischemic Attack.” Available on: http://www.medicinenet.com/transient_ischemic_attack_tia_mini-stroke/article.htm

 

 

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