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Transient ischemic attack

  • Alternative Names

    Mini stroke; TIA; Little stroke


    Symptoms

    Symptoms begin suddenly, last only a short time (from a few minutes to 1 - 2 hours), then disappear completely. They may occur again at a later time. Symptoms usually occur on the same side of the body if more than one body part is involved.

    A TIA is different from a stroke. However, the symptoms of TIA are the same as the symptoms of a stroke and include the sudden development of:

    • Muscle weakness of the face, arm, or leg (usually only on one side of the body)
    • Numbness or tingling on one side of the body
    • Trouble speaking or understanding others who are speaking
    • Problems with eyesight (double vision, loss of all or part of vision)
    • Changes in sensation, involving touch, pain, temperature, pressure, hearing, and taste
    • Change in alertness (sleepiness, less responsive, unconscious, or coma)
    • Personality, mood, or emotional changes
    • Confusion or loss of memory
    • Difficulty swallowing
    • Difficulty writing or reading
    • Lack of coordination and balance, clumsiness, or trouble walking
    • Abnormal sensation of movement (vertigo) or dizziness
    • Lack of control over the bladder or bowels
    • Inability to recognize or identify sensory stimuli (agnosia)

    Signs and tests

    TIAs do not show brain changes on CT or MRI scans. (Most strokes do show changes on such tests.) Because symptoms and signs may have completely disappeared by the time you get to the hospital, a diagnosis of a TIA may be made on based on your medical history alone.

    A physical examination should include a neurological exam, which may be abnormal during an episode but normal after the episode has passed.

    Blood pressure may be high. The doctor will use a stethoscope to listen to your heart and arteries. An abnormal sound called a bruit may be heard when listening to the carotid artery in the neck or other artery. A bruit is caused by irregular blood flow. In some cases, low blood pressure may be seen before symptoms of a TIA occur.

    Tests will be done to rule out a stroke or other disorders that may cause the symptoms.

    • You almost always will have a head CT scan or brain MRI.
    • You may have an angiogram, CT angiogram, or MR angiogram.
    • You may have an echocardiogram if your doctor thinks you may have a blood clot from the heart.
    • Carotid duplex ( ultrasound) can show if the carotid arteries in your neck have narrowed. Cerebral arteriogram reveals which blood vessels is blocked or bleeding.
    • You may have EKG and heart rhythm monitoring tests to check for irregular heart beats.

    Additional tests and procedures may include:

    • Blood clotting tests to rule out a blood disorder
    • Blood chemistry
    • Complete blood count (CBC)
    • C-reaction protein
    • ECG
    • ESR (Sedimentation rate)
    • Serum lipids
    • Tests for syphilis, Lyme disease, and other infections

    Your doctor may use these tests to check high blood pressure, heart disease, diabetes, high cholesterol, and peripheral vascular disease.