Question: When is a stroke not a stroke?
Answer: When it’s a transient ischemic attack.
But, it’s a trick question—because any stroke-like symptoms should be treated as an emergency and be evaluated by medical professionals as soon as possible. If you’re here because you’ve noticed stroke-like symptoms in yourself or a loved one, stop and contact a medical professional ASAP.
Commonly referred to as mini-strokes, transient ischemic attacks (TIAs) result from temporary blockages to blood vessels in the brain, leading to stroke-like symptoms.
They come on suddenly, and often resolve just as quickly—most lasting just a few minutes.
The issue is—this can cause some to write them off, believing the symptom resolution means nothing serious is wrong.
And this is a big mistake. Because here’s the thing about TIAs—they’re often precursors to full-blown strokes.
Think of a transient ischemic attack like a warning shot across the bow. They’re a signal that you should proceed with caution.
While it’s certainly tempting to fly through the yellow light signal of a TIA—triumphant that you made it—it’s really a proverbial canary in a coal mine, who’s warnings you ignore at your peril.
So, what’s the alternative?
Knowledge is! Building your stroke awareness is the key to understanding your risks and recognizing a stroke or mini-stroke if one occurs.
Because the vast majority of major strokes are preventable—and the forewarning offered by a TIA may be the tip off that saves your life or the life of someone you care about.
Let’s spend some time learning about transient ischemic attacks, so you’ll know how to spot one and what steps to take if you ever encounter one in the wild.
What is a Transient Ischemic Attack?
A transient ischemic attack is a stroke that only lasts for a few minutes and then resolves.
But why and how does this occur?
The key to the nature of a TIA lies in its name. So let’s unpack it—
- Transient means something that lasts for only a short time
- Ischemic refers to the blood flow, and points to issues where it’s reduced or restricted
- Attack is just that—an attack
Put these terms together and it shows that a transient ischemic attack is a temporary blockage that impacts the blood vessels that serve the brain.
In most cases, TIAs only last for a few minutes, before resolving as quickly as they came on.
But here’s the thing—according to research, TIAs are highly predictive that a bigger neurological event may be looming on the horizon.
The risks for a larger stroke event within 90 days after a transient ischemic attack are between 2-17%.
So, what can you do with this information to support your health and wellbeing?
You can learn to recognize the common signs and symptoms of stroke and TIA, so you’ll know what to do if you ever encounter one.
Let’s review them now.
What Are the Signs and Symptoms of a Transient Ischemic Attack?
Because a transient ischemic attack is like a mini-stroke, its common signs and symptoms tend to mimic those of a larger stroke event.
So, when a TIA occurs, you can expect to notice issues like—
- Weakness, numbness, or paralysis on one side of the body, particularly in the legs, arms, and face (because strokes typically impact one side of the brain, and the opposite side of the body)
- Speech issues, including slurring, word finding trouble, garbled speech, speaking nonsensically, or difficulty understanding others
- Sudden difficulties with balance and coordination when standing and walking
- Sudden episodes of dizziness, visual changes, or severe headache
If you notice any of these issues in yourself or someone you love, it’s vital to seek out medical evaluation as soon as possible.
Ok, but why is it so important to get medical attention for a suspected TIA, even if your symptoms resolve? Great question. Let’s tackle that one next.
Why is a Rapid Medical Response So Important in TIA Diagnosis and Treatment?
For one thing, it’s difficult to distinguish the symptoms of a TIA from those of a larger stroke.
For another, a prompt medical assessment is often key to pinpointing the cause of a TIA and determining the best course of treatment to prevent further issues.
As we discussed at length in our recent article on ischemic strokes, prompt treatment is crucial when it comes to stroke prognosis and survival. It’s strongly recommended to dial 911 if you suspect you or a loved one is experiencing a stroke.
This is because EMS can perform testing and life-saving treatment en route to the hospital, and can set up and streamline the medical evaluation and treatment process.
Here’s an article with additional information on why emergency medical services are a vital component of the acute stroke care continuum.
Once you arrive at the hospital with a suspected TIA, you can expect a few things—
- First, your healthcare team will obtain your medical history and assess your symptoms
- They’ll likely order imaging tests to view the blood vessels in your head and neck
- They may order additional neurological assessments, such as MRIs or CT scans
- If it’s determined you’ve experienced a TIA, they’ll want you to follow up with a neurologist, to further assess the event and determine your risk for future strokes
Now that you know what a TIA is and what you should do if you suspect one, let’s explore some of the biggest risk factors for transient ischemic attack.
What Are the Risk Factors for Transient Ischemic Attacks?
The major risk factors for a TIA are the same as those for ischemic stroke. Preventing strokes and transient ischemic attacks means building your awareness and understanding of your personal risk factors for these issues.
Because many of the risk factors for stroke and TIA are within your ability to manage and control, by making wise healthcare and lifestyle choices that support your overall health and wellbeing.
It’s beneficial to break down the risk factors for transient ischemic attack into two primary categories, in order to separate out those that are within your control from those you should be aware of but can’t change.
TIA risk factors that can’t be changed include—
- Age—the risks for stroke increase with age, especially over the age of 55
- Genetics—those with a family history of stroke are more likely to have one. Also, those with inherited issues like Sickle Cell Disease are at increased risk for TIA and stroke
- Gender—men have a slightly higher risk for stroke and TIA, but women’s risk increases as they age
- History—if you’ve had a TIA, you’re at increased risk for another one
Ok, now for some good news. Because most of the risk factors for TIA and stroke are manageable with lifestyle changes and medical interventions.
Modifiable TIA risk factors include health conditions like—
- High blood pressure
- High cholesterol
- Cardiovascular diseases and conditions (such as atrial fibrillation)
- Peripheral artery disease
- Carotid artery disease
Additional modifiable TIA risk factors associated with lifestyle choices include—
- Excessive alcohol consumption
- Sedentary lifestyle
- Poor nutrition
- Use of illicit drugs (such as cocaine)
If you recognize any of these risk factors in yourself or a loved one, focusing on improving and managing any within your control will have a positive impact on reducing your risks for strokes and TIAs.
Medical issues like high blood pressure, high cholesterol, and diabetes can be effectively managed with the support and guidance of a qualified healthcare provider, who may prescribe medications or other treatments to address these issues.
Take heart in the fact that up to 80% of strokes can be prevented with a combination of lifestyle changes and medical interventions.
So much of your stroke prevention power lies with you and the choices you make for your health and wellbeing.
For many people, a transient ischemic attack may be the wake up call needed to get your healthy habits on track and to more closely monitor your medical status with support from your doctor.
Because you can make an impact on lowering your stroke risk. The choice is in your hands.
Next, let’s take a look at how TIAs are diagnosed and treated, since this differs from the typical process for an acute stroke.
How Are Transient Ischemic Attacks Diagnosed and Treated?
TIAs can be a bit tricky to diagnose, for three main reasons—
- The first is the symptoms of transient ischemic attack can mimic those of other neurological issues, such as migraine auras or seizures. This article explains the challenges of TIA differential diagnosis, due to these mimic conditions.
- Usually, by the time a TIA event is assessed by medical professionals, the outward signs and symptoms have resolved. This is why medical history, patient interviewing, and brain imaging and blood testing are used to help doctors determine if a transient ischemic attack was the cause of the episode.
- The third reason TIAs can be difficult to pinpoint is because of their nature. On a brain scan, the damage inflicted by a transient ischemic attack is like a needle in a haystack. Whereas a major stroke leaves clear evidence of the areas it’s damaged, a TIA can look like a pinprick spot on an otherwise healthy brain scan, making the area impacted difficult to locate. The earlier an MRI or CT scan can be completed, post TIA occurrence, the better the chances it can locate the area impacted.
In addition to assessing the brain with imaging tools and tests, doctors may seek to check the health of the carotid arteries, to see if these major vessels leading from the heart to the brain have any signs of stiffening or blockages.
If your doctor determines you’ve experienced a TIA, they’ll work to get a clear picture of your cardiovascular health and risk factors for a major stroke. This helps them determine if medication to reduce blood clots or procedures to remove plaque deposits from the arteries that feed your brain are an appropriate course of treatment.
Because TIA symptoms come and go so quickly, further hospitalization and rehabilitation are rarely needed as with a major stroke.
The primary goal of transient ischemic attack treatment is to prevent a larger stroke from occurring in the future.
If you’re concerned or interested about how healthcare professionals approach follow-up care for TIAs, this helpful video from the American Heart Association can offer some insight.
With any kind of stroke, awareness and action are the keys to managing your risks. Even if symptoms disappear and resolve on their own, they should never be ignored.
If you or someone you love experiences symptoms consistent with a transient ischemic attack, the wise course of action is to seek out assessment from a qualified medical professional.
Because it’s always better to be safe than sorry. And a TIA may provide the advance warning needed to ward off a larger stroke in the near future.
After all, you wouldn’t ignore a smoke alarm if it suddenly started blaring, right? A TIA is a clear warning that larger neurological issues are brewing below the surface.
As they say—where there’s smoke, there’s fire.