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Migraine is a complex and often confusing disease. The symptoms of Migraine can also be symptoms of other conditions and events including transient ischemic attack (TIA). Add to that the fact that having Migraine disease puts Migraineurs at increased risk of cardiovascular events such as TIA, and it becomes essential that we learn about TIA.

Having a TIA increases the risk of having a stroke that can occur weeks or months later. More than 33% of those who have a TIA are expected to eventually have a stroke. In approximately 50% of cases of stroke following TIA, the stroke occurs within a year of the TIA; 20% experience a stroke within 90 days.2

What is Transient Ischemic Attack?

A transient ischemic attack (TIA) is a transient stroke that lasts only a few minutes, a temporary blood clot in the brain. It occurs when the blood supply to part of the brain is briefly interrupted by that clot.

There are different potential causes of TIA:

  • Stenosis: reduced blood flow at a narrow spot in a major artery leading to the brain.
  • Embolism: a blood clot in the heart of another part of the body breaks off and travels to the brain, blocking a blood vessel.
  • Thrombosis: a narrowing in one of the small blood vessels in the brain temporarily blocks blood flow.

Symptoms of TIA

TIA symptoms, which usually occur suddenly, are similar to those of stroke but do not last as long. Most symptoms of a TIA disappear within an hour, although they may persist for up to 24 hours. Most symptoms of TIA last less than five minutes. The primary symptoms and warning signs are:

  • sudden numbness or weakness in the face, arm, or leg, especially on one side of the body;
  • sudden confusion or difficulty in talking or understanding speech;
  • sudden trouble seeing in one or both eyes;
  • sudden difficulty with walking, dizziness, or loss of balance and coordination;
  • sudden, severe headache.

Risk factors:

  • smoking;
  • being overweight, body mass index of 25 or higher;
  • a diet high in sodium, trans fat and / or saturated fat;
  • excessive consumption of alcohol;
  • hypertension - for most people, blood pressure should be 120/80 or lower;
  • hyperlipidemia (high cholesterol);
  • type 2 diabetes;
  • Migraine disease.

Treatment of TIA:

Because there is no way to tell whether symptoms are from a TIA or an acute stroke, patients should assume that all stroke-like symptoms signal an emergency and should not wait to see if they go away. A prompt evaluation (within 60 minutes) is necessary to identify the cause of the TIA and determine appropriate therapy. Depending on a patient's medical history and the results of a medical examination, the doctor may recommend drug therapy or surgery to reduce the risk of stroke in people who have had a TIA. The use of antiplatelet agents, particularly aspirin, is a standard treatment for patients at risk for stroke. People with atrial fibrillation (irregular beating of the heart) may be prescribed anticoagulants.1

Summary and comments:

A question that frequently arises is how to tell the difference between a Migraine and a TIA or between a Migraine and a stroke. This is an excellent question. The answer is that there are times when only a doctor can tell the difference because some symptoms could be Migraine, TIA, or stroke. When there is any doubt, the only safe course of action is to see a doctor or go to the emergency room as quickly as possible. As stated above, a prompt evaluation and treatment is essential to minimize damage and speed recovery.

Important to-do's:

  • Learn the warning signs of TIA and stroke.
  • Discuss Migraine, TIA, and stroke symptoms with your doctor until you understand when you need to call your doctor or go to the ER.
  • Discuss reducing your modifiable risk factors with your doctor.

Bottom line: If you're in doubt, check it out! Don't worry about feeling silly if it's "just a Migraine." Be safe.

Related information:


Resources:

1 Office of Communications and Public Liaison. "NINDS Transient Ischemic Attack Information Page." National Institute of Neurological Diseases and Stroke. October 15, 2010.

2 "All About TIA." TalkAboutTIA.com.

Medical review by John Claude Krusz, PhD, MD

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