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Transient Ischemic Attack

Many physicians say that a transient ischemic attack (TIA) is to a stroke what chest pains are to a heart attack--a warning sign that a more serious medical event may take place. In fact, says Farzaneh Sorond, M.D., a consulting cerebrovascular neurologist at Hebrew Rehabilitation Center, TIA is a far from insignificant event. As many as one out of three people who suffer a transient ischemic attack go on to have a stroke. 

Definition

A warning stroke in which a blood vessel obstruction occurs for a short time and tends to resolve itself through normal mechanisms.

Causes

  • Temporary decrease in blood supply to part of the brain
  • Blood clot moving to the brain from another part of the body, most commonly the heart
  • Buildup of cholesterol-laden plaques in an artery that supplies oxygen to the brain

Symptoms

  • Sudden numbness, weakness or paralysis of the face, arm or leg, usually on one side
  • Difficulty speaking
  • Sudden blurred or double vision
  • Dizziness or loss of balance

Symptoms typically disappear within one hour and all affects are gone within 24 hours.

Risk Factors

  • Family history of TIA or stroke
  • Age (risk increases as you get older)
  • Race (African-Americans are at higher risk)
  • Gender (men more than women)
  • High blood pressure
  • High cholesterol
  • Cigarette smoking
  • Diabetes
  • Obesity
  • Cardiovascular disease
  • Elevated homocysteine level
  • Carotid artery disease
  • Sedentary lifestyle

Diagnosis

  • Physical examination
  • Brain imaging by computerized tomography scan (CT scan) or magnetic resonance imaging (MRI)
  • Vascular studies such as carotid ultrasonography, vascular imaging (CT angiogram or magnetic resonance angiogram), or transcranial Doppler ultrasound 
  • Echocardiography
  • Blood test to exclude a clotting disorder

Treatment

  • Anticoagulants
  • Anti-platelet medications
  • Carotid angioplasty and stenting
  • Carotid endarterectomy

Glossary

Anticoagulants - drugs that prevent blood clots from forming or existing clots from growing larger.

Anti-platelet medications- drugs that make platelets (a circulating blood-cell type that assists in blood clot formation) less likely to stick together.

Ateriography - the injection of dye visible by X-ray into the bloodstream to evaluate blocked or damaged arteries.

Cardiovascular disease - diseases of the heart and blood vessels.

Carotid angioplasty and stenting - the insertion of a stent (a wire-mesh scaffold) into the carotid artery in the neck via a catheter (a thin, hollow tube) to keep the artery open.

Carotid artery disease - a disease that occurs when the major arteries in the neck become narrowed or blocked.

Carotid endarterectomy - a procedure in which a surgeon removes the inner lining of the carotid artery if it has become thickened or damaged by plaques that restrict blood flow.

Carotid ultrasonography - a test that uses high-frequency sound waves to determine if there is narrowing of or plaque formation in the carotid artery.

Cholesterol - a waxy, fat-like substance in every cell in the body and in many foods.

Computerized tomography angiogram - an examination that uses X-rays and computer technology to visualize blood flow in arteries and veins throughout the body.

Computerized tomography (CT) scan - a noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images of the body, showing detailed images of bone, muscle, fat and organs.

Diabetes - a chronic medical disorder in which blood glucose (sugar) levels are abnormally high because the body does not release or use insulin adequately to remove sugar from the blood stream.

Echocardiography - an ultrasound of the heart that provides an accurate assessment of the heart's overall health and can diagnose abnormalities which may lead to clot formation.

High blood pressure - a medical condition in which blood pressure (the force applied to the walls of arteries as the heart pumps blood throughout the body) is consistently higher than 120/80.

High cholesterol - elevated levels of cholesterol, a fatty substance found in the circulating blood of humans; high levels of LDL (bad cholesterol) are associated with coronary heart disease.

Homocysteine - an amino acid (a building block of protein) in the blood, high amounts of which can damage the lining of arteries and promote blood clot formation.

Magnetic resonance angiogram - a diagnostic procedure that uses a combination of large magnets, radiofrequencies and computers to produce images of blood vessels.

Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies and computers to produce detailed images of organs and structures in the body.

Plaque - the accumulation of fatty deposits on blood vessel walls.

Stroke - a cardiovascular disease that affects the arteries leading to and within the brain and prevents needed blood and oxygen from reaching the brain.

Transcranial Doppler ultrasound - a test that uses high-frequency sound waves to determine if there is narrowing of or plaque formation in the blood vessels of the brain.

Links

American Stroke Association - www.strokeassociation.org
National Stroke Association - www.stroke.org
National Institute of Neurological Disorders and Stroke - www.ninds.nih.gov

Disclaimer
The information contained on this Web site is intended for general consumer understanding and education. The information is provided as a resource only and is not a substitute for professional diagnosis and treatment. Access to the information on this site is voluntary. We advise users to consult their physician or other qualified health-care professional if they have questions regarding personal health and medical conditions. Hebrew SeniorLife expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury or liability whatsoever suffered as a result of your reliance on the information contained on this site.

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