Transient Ischemic Attack

Transient Ischemic Attack, also known as mini-stroke due to similar symptoms, is a neurological event. Unlike stroke, this lasts for only few minutes without causing any permanent damage. The main role of the brain is to respond to receive signals provided by the five senses (touch, taste, smell, sight and hearing), and send signals to the body for functioning of the motor. The information is processed by the brain through both conscious and unconscious thoughts through the nervous systems. It controls the basic functions of the body, such as breathing, temperature control and heart rate. The four arteries, two carotid arteries and two vertebral arteries are present in the neck, which supplies blood to the brain. When these arteries get narrowed, there is a temporary lack of adequate oxygen and blood that travels to the brain, resulting into an attack. It can create problems with vision, weakness, dizziness and trouble in speaking. Although TIA is a stroke that resolves on its own, you might be at high risk of getting a major stroke in future, if not treated on time. It has been seen that people with TIA are at 25 percent greater risk to have a stroke or other serious complications within three months. According to a study, about 10 per cent of the people being followed for 90 days after the attack had strokes, in which half of them had in just two days. A Transient Ischemic Attack serves both as an opportunity and a warning- opportunity to take preventive steps and warning of a stroke in the near future.

Symptoms:

The attack lasts for around 2 to 30 minutes but may take up to 24 hours in order to return completely to normal functioning. About 1 in 3 people suffer from a stroke if they previously had TIA. The symptoms of Transient Ischemic Attack may include the sudden arrival of:

-  Loss of coordination or balance

-  Dizziness

-  Unclear speech

-  Difficulty in understanding others

-  Paralysis or numbness in your arm, leg, or face, usually on one sis of the body

-  Feeling weak

-  A severe headache

-  Blindness in one, or both eyes

The symptoms of TIA depend on the intensity and location of the blood limitation to the brain. When a narrowed carotid artery clogs the ophthalmic artery, which supplies blood to the retina, it causes transient blindness in one eye. If the blood loss takes place in the middle cerebral artery, a symptom of weakness or paralysis of one side of the body, or just one limb, is observed. The speech centres are located on the left side of the body. If this side gets attacked by stroke, there may be trouble in speaking or understanding words. Strokes in vertebral arteries reduce the supply of blood to the base of the brain that may cause a sudden collapse, such as falling suddenly while standing or walking and then recover quickly. You may incur more than one Transient Ischemic Attack. Depending on the area of the brain that is involved the recurring symptoms may be different or similar.

Causes:

Usually the causes of Transient Ischemic Attack are triggered by the cholesterol-containing fatty deposits known as plaques. Its formation in the wall of the blood vessel is called atherosclerosis, which means hardening of the arteries. The arteries supply nutrients and oxygen to your brain. These plaques are capable of decreasing the flow of blood through an artery or can lead to the growth of a clot, which then forms and block the blood vessel. When wastes from narrowing of a carotid artery break off and drift downstream to cause obstruction it create a blockage. Sometimes, small blood clots can develop within the heart of people who have an irregular heartbeat called atrial fibrillation. These clots can travel to the brain and cause the blockage. A weak spot in a blood vessel, which is called aneurysm, ruptures and spills blood into the tissue of the brain, causing a brain haemorrhage. It can also happen because of spontaneous bleeding caused due to an uncontrolled high blood pressure. If such bleeding occurs then it may result in permanent damage of a stroke. It would not resolve on its own so as to be classified as a Transient Ischemic Attack.

How is it diagnosed?

A Transient Ischemic Attack should be considered as a warning sign that might appear as a stroke in future. It is important to get a prompt evaluation of the symptoms in order to diagnose the causes of Transient Ischemic Attack and to decide the method to be used for treatment. The doctor may rely on the following methods in order to determine the cause of the attack and to assess the risk of stroke.

-  The doctor may do the physical examination or ask for certain tests to be done for the risk factors of a stroke, which includes high blood pressure, high levels of amino acid homocysteine, high cholesterol and diabetes.

-  He may check for a particular sound over your arteries, which indicates atherosclerosis.

-  Carotid ultrasonography is done with the help of a device called transducer, which sends sound waves of high frequency into your neck. The sound waves that pass through your tissue and back produce images on a screen, which is checked by the doctor to look for clotting or narrowing of the carotid arteries.

-  The doctor will check for a regular heartbeat to rule out the atrial fibrillation presence.

-  The legs and arms are examined for sensation, power and tone.

-  Balance and coordination are checked.

-  CT scan of your head.

-  CAT scan of neck and head.

-  MRI of the brain.

-  MRA of neck and head.

-  Echocardiography and Arteriography.

Prevention:

It is important to know the risk factors and live a healthy life in order to prevent a Transient Ischemic Attack. To know what is the preventive measure for Transient Ischemic Attack, follow the below mentioned:

-  Stop smoking and limit the alcohol consumption to reduce the risk of Transient Ischemic Attack or a stroke.

-  In the case of high blood pressure, you must exercise regularly so that you can lower your blood pressure without drugs.

-  Having plenty of fruits and vegetables will protect you against TIA as these contain nutrients like antioxidants, potassium and folate.

-  Excluding fat and cholesterol intake, especially trans fat and saturated fat, from your diet may decrease the growth of plaques in your arteries.

-  Manage your diabetes with proper diet, medication and exercise on daily basis.

-  People having overweight are at greater risk to TIA as it contributes to other risk factors like diabetes, high blood pressure and cardiovascular disease. Lose weight by doing exercises and a planned diet in order to improve your cholesterol level and lower the blood pressure.

-  People with high blood pressure should avoid foods that are salty in taste. They should not add extra salt to food. Although, taking sodium in excess may increase your blood pressure if you are sensitive to it, and it may not prevent hypertension, but avoiding it will help in reducing the blood pressure.

-  Don’t use illicit drugs, such as cocaine, as these are associated with a higher risk of Transient Ischemic Attack or a stroke.

Treatment:

The signs of Transient Ischemic Attack resemble those found in a stroke of early stage, but disappears within an hour. After determining the causes of this attack it is important to get the treatment in order to correct the abnormalities and prevent stroke.

-  Several medications are used to reduce the possibility of a stroke after a TIA, which depends on the cause, severity, type and location of TIA. You may be prescribed antiplatelet drugs, which make your platelets less likely to stick together. Anticoagulants like Coumadin and Jantoven, which has heparin and warfarin, affects the clotting-system proteins. While warfarin is used over a longer term, heparin is used for a short time. Thrombolytic therapy is used in certain cases to treat a stroke that is ongoing. It dissolves blood clots that are blocking the flow of blood to the brain.

-  Your doctor may recommend a surgery, carotid endarterectomy if you have a moderate or severe narrow carotid artery. The fatty deposits are cleared before the occurrence of another stroke or TIA.

-  Carotid angioplasty is a procedure which is performed in selected cases. The process involves opening of a clogged artery by using a balloon-like device and placing a stent into the artery in order to keep it open.

Complications:

It is essential to have some knowledge of TIA complications so as to plan prevention strategies. Following are some of the major risk factors that result in Transient Ischemic Attack:

-  Diabetes can increase the atherosclerosis severity in which the arteries get narrowed due to fatty deposits accumulation, resulting in a TIA.

-  Your age is the most important factor as it determines how near you could be to the risk of getting a TIA. Especially after 55 years old, the rate of having a stroke doubles in every 10 years. The rate of mortality is higher among women aged between 45 and 54 years.

-  Eating uncontrolled amount of cholesterol and fat can put you in a risk zone of TIA.

-  You may pose to a great risk if the reading of blood pressure is higher than 140/90 mm Hg.

-  If any of your family members has had a Transient Ischemic Attack earlier, then you may be at greater risk.

Myths:

You must get proper treatment as per your signs and symptoms of Transient Ischemic Attack. The myths associated with stroke are as common as the stroke itself which most people don’t realize. Mentioned below are the truth you should know.

Myth #1: Transient Ischemic Attack happens to only elderly people:

The fact is, there is an increasing number of a stroke in peoples aged between 18 and 65. Young people are at greater risk due to their obesity and high blood pressure.

Myth #2: It takes place in the heart:

The truth is, a TIA takes place in the brain when the blood supply to the neurons gets obstructed due to either blood clot or a disease of the blood vessels.

Myth #3: Strokes are not preventive and cannot be treated:

But according to a study, while a TIA recovers on its own within an hour, 90 percent of strokes can be prevented to a great extent and can be treated if the patient is taken to the hospital within 4 and a half hours of the beginning of its symptoms.

Myth #4: You don’t need treatment if the symptoms of a TAI go away:

As per the facts, when someone has suffered a Transient Ischemic Attack, it should be considered as a medical emergency. It is because they become prone to have a stroke within a week.

Myth #5: Pain is the most common symptom of a TIA:

The truth is, pain is not a reliable symptom, as only a few people get a headache. There are few other signs, such as confusion, double vision, weakness or numbness on one side of the body, trouble is speaking and lack of coordination.

Myth #6: TIA is not genetic:

The fact is, diabetes, obesity, blood vessels abnormalities, cardiac tumours and clotting disorders are the complications that can get inherited from generation to generation.

Conclusion:

If you ever suspect Transient Ischemic Attack, it is crucial to seek medical help as soon as possible. The carotid artery is cleaned by operating and restoring the normal flow of the blood through the artery so as to reduce the occurrence of later stroke. In the case of the narrowed carotid artery with no symptoms, a person can reduce the risk of having a stroke with the help of medications like aspirin. These types of blood thinners partially block the function of the platelets that help in blood clotting. Although the attack is short and does not cause damage that would last for long, it should still be treated like an emergency. It needs an immediate medical attention because prompt assessment and identification of conditions that can be potentially treated may help the person prevent a stroke.

Last updated on : 14-09-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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