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Transient ischemic attack

• Overview
• Symptoms
• Treatment
• Prevention

Definition:

A transient ischemic attack is a "mini-stroke" caused by temporary disturbance of blood supply to an area of the brain, which results in a sudden, brief decrease in brain function.

Alternative Names:

Mini stroke; TIA; Little stroke

Causes, incidence, and risk factors:

In a TIA, the blood supply is only temporarily blocked. For example, a blood clot may dissolve and allow blood to flow normally again.

A TIA is different than a small stroke. The symptoms of TIAs go away in less than 24 hours, usually less than one hour. TIAs do not show lasting changes on CT or MRI scans. (Small strokes do show changes on such tests.) TIAs are like warnings that a true stroke may happen in the future if something is not done to prevent one.

A brief interruption in the blood flow to the brain can cause a decrease in brain function. This is called a neurologic deficit. Too little blood flow to the brain for some time can cause brain cells to die.

The loss of blood flow to the brain can be caused by:

• Narrowing of a blood vessel
• Blood clot within an artery of the brain
• Blood clot that travels to the brain from somewhere else in the body (for example, the heart)
• Injury to blood vessels

Atherosclerosis ("hardening of the arteries") is a condition where fatty deposits occur on the inner lining of the arteries. This condition dramatically increases the risk for both TIAs and stroke. Approximately 80-90% of people who have a stroke due to atherosclerosis had a TIA episode before.

Less common causes of TIA include:

• Blood disorders (including polycythemia, sickle cell anemia, and hyperviscosity syndromes where the blood is very thick)
• Spasm of the small arteries in the brain
• Problems with blood vessels caused by disorders such as fibromuscular dysplasia, inflammation of the arteries (arteritis, polyarteritis, granulomatous angiitis), systemic lupus erythematosus, and syphilis.

In some cases, hypotension (low blood pressure) may be seen before symptoms of a TIA occur. Other risks for TIA include high blood pressure (hypertension), heart disease, migraine headaches, smoking, diabetes, and increasing age.

About a third of those diagnosed with TIA will later have a stroke. TIAs are more common among men and black people.

References:

Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation . 2007; Published online before print February 19, 2007.

• Review Date: 2/20/2007
• Reviewed By: Updated by: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.(2006)

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