What is TIA or Transient Ischemic Attack?
A Transient Ischemic Attack or TIA, otherwise referred to as a mini stroke, is a body condition when there is an alteration in the amount of blood supplied to a specific area of the brain which results in brief neurological dysfunction persisting for no more than 24 hours.
Causes of Transient Ischemic Attack
The common cause of Transient Ischemic Attack is an embolus that obstructs an artery situated in the brain. This situation arises due to a dislodged atherosclertic plaque in any of the numerous carotid arteries present in the neck and brain or from a blood clot or thrombus in the heart due to atrial fibrillation.
Other causes of TIA may include excessive narrowing of vessels due to atherosclerotic plaque and enhanced blood viscosity which may set in as a result of some blood diseases. Transient Ischemic Attack can be co related to a few other medical conditions such as hypertension, Migraine, heart disease such as atrial fibrillation, nicotine smoking, diabetes mellitus and hypercholesterolemia.
Medication for Transient Ischemic Attack
Doctors may prescribe anti coagulant medications, warfarin, heparin or anti platelet medications like aspirin which prevent the platelets from bunching together and thin the blood to treat TIA. Thus, small particles cannot be formed and travel and reach the brain. Administering of such drugs require frequent monitoring as they have side effects, such as bleeding from mild trauma and easy bruising.
Prevention of Transient Ischemic Attack
Preventive steps for TIA include controlling the various risk factors like diabetes, high BP, heart disease and other disorders which are associated with it. Smokers should give up smoking.
Risk Factors related to TIA
- A family history of TIA or stroke substantially increases the chances of experiencing TIA.
- People above the age of 55 are at a greater risk.
- Men are at a higher risk than women but more women are likely to die in case of a stroke.
- African Americans are at a higher risk of dying from strokes due to high incidences of BP and diabetes mellitus.
Symptoms of TIA
The symptoms of TIA may vary from person to person, and are based on the area of the brain which is affected and involved. Some of the frequent and common symptoms of Transient Ischemic Attack include:
- Temporary loss of vision
- Weakness experienced in any side of the body
- Difficulty in speaking
- Numbness and tingling sensation on one side of the person
Loss of consciousness is rare. There have been some cases of partial and temporary paralysis affecting the tongue and face of the afflicted person.
Symptoms are temporary and of short duration, lasting for a few seconds to minutes and usually disappear within an hour. Lack of coordination, dizziness and poor balance may also be related to Transient Ischemic Attack.
Treatment of Transient Ischemic Attack
The main line of treatment after successful recovery from Transient Ischemic Attack should be to properly diagnose the cause and treat it accordingly. It is sometimes difficult to differentiate between TIA and stroke. The cause for the condition should be quickly established by imaging the brain.
If the ECG reveals atrial fibrillation or arrhythmias or the Echo cardiogram shows thrombus in the heart chambers, anti coagulation medications can be beneficial.
The first line of treatment is administering aspirin, the next line is clopidogrel and the third one is ticlopidine. In case TIA re occurs even after aspirin treatment, a combination of dipyridamole and aspirin (Aggremox) may be prescribed.
If the Transient Ischemic Attack affects any brain area which is supplied by carotid arteries, a TCD scan may reveal carotid stenosis. In case a person has more than 70% stenosis in the carotid artery, the doctor may suggest removal of the atherosclerotic plaque through a surgical procedure or through a carotid endarterectomy.
One complication which can occur during the surgical procedure is a stroke which may occur during or after the surgery. Some patients are given clopidogrel or modified release dipyridamole to reduce the chances of reoccurrence of such an attack.
ACE inhibitors may also b administered, with an aim not to lower blood pressure too quickly as this may lead to ischemic injury because of low perfusion pressure.
Types of TIA
If the symptoms which charecterise Transient Ischemic Attack persist for a longer period of time, they are categorized as strokes. In case a cerebral infarct lasts longer than a day but less than 72 hours, it is referred to as RIND or reversible ischemic neurological deficit.