Transient ischemic attack (TIA) – spot the signs

Sometimes known as a mini-stroke, a TIA can signal you’re at high risk of a full stroke – find out what to do if you have symptoms.

What are the symptoms?

What causes a TIA?

Who can be affected?

When to see a doctor 

How is a TIA diagnosed?

What are the treatments?

Self-care and prevention

Where to get support

A transient ischemic attack (TIA) may only last a short time, but it needs to be taken seriously and requires urgent medical care, as it could be a stroke. If you’re diagnosed with a TIA, it means you’re at high risk of having a stroke, so you can see it as an urgent prompt to make changes and prevent more serious problems. 

A transient ischemic attack (TIA) is a type of stroke that only lasts for a short time. Typically, symptoms go away within 1 or 2 hours, although they can persist for up to 24 hours. 

TIAs are sometimes known as mini-strokes, which can make them seem less concerning. But a TIA is a medical emergency, because it can suggest you’re at high risk of a life-threatening full [stroke](https://www.livehealthily.com/health-library/conditions/stroke). 

__At the first sign of symptoms of a TIA or stroke, call for an emergency ambulance. __

Almost 1 in 5 people with a suspected TIA go on to have a stroke within 90 days. It’s also vital to get checked out in hospital so that doctors can confirm what’s causing your symptoms  – 2 in 5 of those with a suspected TIA turn out to have had a stroke. 

## What are the symptoms?

A TIA causes sudden symptoms that are almost identical to a stroke. The difference is that a TIA stops on its own, so symptoms don’t last as long, usually easing within 1 or 2 hours. They can include a combination or just 1 of the following: 

- loss of muscle control in the face, arm or leg, usually on 1 side of the body
- trouble speaking or understanding what others are saying
- confusion
- loss of sight, blurred or double vision in 1 or both eyes
- difficulty walking, loss of balance, and coordination
- nausea or being sick
- a problem with swallowing
- dizziness
- a new, sudden severe headache you haven’t experienced before
- losing consciousness. 

You can remember the key symptoms of a stroke or TIA with the word FAST:
- __Face__ – someone’s face may droop on 1 side, or become numb, and they may not be able to smile evenly
- __Arms__ – 1 arm may be weak or numb, and raising it may be difficult
- __Speech__ – may be slurred or garbled
- __Time__ – every minute counts, so call an ambulance if you or someone else has these symptoms. 

Always call an ambulance if you or someone else is experiencing these symptoms. Never wait to see if symptoms ease. Even if they do go away, you still need urgent medical help, as you could be at risk of having a full stroke soon. 


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## What causes a TIA?

‘Ischemic’ means reduced blood flow, and a TIA happens when the blood supply to part of the brain is temporarily cut off or reduced, so the cells there don’t get the oxygen they need. 

This is usually caused by a blood clot that’s formed somewhere in your body and moved to the blood vessels that supply the brain. Or the blockage could be the result of fatty material or blood vessels. 

In a full stroke, the blood supply is cut off for so long that brain cells die, which can be life-threatening, or result in long-term issues. 

When you have a TIA, the blockage clears and blood supply is restored before brain tissue dies, so symptoms go away.


## Who can be affected?

TIAs and stroke share similar risk factors that make it more likely for someone to have a TIA, including:

- conditions such as [high blood pressure](https://www.livehealthily.com/health-library/conditions/blood-pressure-high), diabetes, [atrial fibrillation](https://www.livehealthily.com/health-library/conditions/atrial-fibrillation), high cholesterol and heart disease
- being overweight or obese
- having a diet high in fat and salt
- smoking or vaping
- drinking too much alcohol 
- having had a previous [stroke](https://www.livehealthily.com/health-library/conditions/stroke) – a TIA can be a warning sign of another one
- having had a previous [heart attack](https://www.livehealthily.com/health-library/conditions/heart-attack), especially if it was recent 
- age – rates of all types of stroke double every 10 years after 55. Blood vessels become less flexible with age, so are more likely to narrow and/or get blocked by a clot.


## When to see a doctor 

Any kind of stroke is an emergency, including a TIA. If you’re experiencing the [FAST symptoms](https://www.livehealthily.com/health-library/conditions/transient-ischaemic-attack#symptoms), or someone else is, call an ambulance immediately. 

Don’t try to make your own way, or let someone else take you, as that may cause crucial delays. Medical professionals  can start treatment for a suspected stroke or TIA right away, before you get to the hospital. 

If you’ve had a TIA, your symptoms may have gone by the time you get to the hospital, but you should still be evaluated as soon as possible, for an accurate diagnosis and swift treatment to reduce your risk of stroke. 


## How is a TIA diagnosed?

Your healthcare professional will ask questions about your symptoms and medical history. 

You may have a range of tests to help identify the cause of a TIA, including blood pressure tests, blood tests to check for things like high cholesterol and diabetes, and an electrocardiogram (ECG), to detect abnormal heart rhythms.

If it’s not clear which part of your brain was affected, a brain scan may be carried out. 


## What are the treatments?

Treatment depends on the cause. It is likely to include medicines to lower cholesterol, such as statins, and reduce blood clotting, such as aspirin, and sometimes anticoagulants (depending on the stroke type), which help to ‘thin’ the blood. 

However, it’s vital to pinpoint and treat whatever caused the TIA. Without treatment, you could be at very high risk of having a stroke within the next 90 days, especially in the first 2 days. 

You may also be given specific medicines to treat underlying conditions such as atrial fibrillation and high blood pressure – managing these conditions can reduce the risk of stroke.

Some people may need a procedure or surgery to open up narrowed arteries, so they’re less likely to get blocked again.

Making some lifestyle changes can help reduce your chances of having a stroke after a TIA.


## Self-care and prevention

A TIA can be seen as a wake-up call to take better care of your health, and it’s very important to follow your healthcare professional’s advice, including taking any medication they’ve prescribed.

But whether or not you’ve had a TIA, the same self-care steps can help to prevent future problems. Your healthcare professional can give guidance specific to you, but these are some of the ways everyone can reduce their risk of a TIA or stroke:

- __reaching and maintaining a healthy weight__
- __eating a healthy diet__ (low-fat, reduced salt, high-fiber, and including lots of fresh fruit and vegetables)
- __staying active__
- __limiting alcohol intake__
- __quitting if you smoke__. 


## Where to get support

If you’ve had a TIA or stroke, or want to know more about risks and prevention, try a support group, including:

- [American Stroke Association](https://www.stroke.org/)
- [World Stroke Organization](https://www.world-stroke.org)
- [Stroke Association (UK)](https://www.stroke.org.uk/)


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References

Charlotte Haigh

Jo Wheatley

Dr Emily Blount

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