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Transient Ischemic Attack (TIA)

A condition in which blood flow to the brain is temporarily blocked.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)

About Transient Ischemic Attack (TIA)

A transient ischemic attack (TIA) is a transient stroke that lasts only a few minutes. It occurs when the blood supply to part of the brain is briefly interrupted. 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. Symptoms can include: numbness or weakness in the face, arm, or leg, especially on one side of the body; confusion or difficulty in talking or understanding speech; trouble seeing in one or both eyes; and difficulty with walking, dizziness, or loss of balance and coordination.

Is there any treatment?

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....Read more about Transient Ischemic Attack (TIA) NIH - National Institute of Neurological Diseases and Stroke

What works? Research summarized

Evidence reviews

Vitamin K antagonists versus antiplatelet therapy after transient ischaemic attack or minor ischaemic stroke of presumed arterial origin

People who have a stroke due to a blockage of an artery have a higher risk of having another possibly fatal stroke, or a heart attack. Treatment with antiplatelet drugs (like aspirin) definitely reduces this risk. Blood thinning treatment (anticoagulation by vitamin K antagonists) was believed to provide added protection. We reviewed eight trials involving 5762 participants that compared anticoagulants with antiplatelet agents for preventing recurrent stroke and found no benefit of low intensity anticoagulation over aspirin, and an increased risk of bleeding with high intensity anticoagulation.

Anticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischaemic attack

Anticoagulants are beneficial and safe for preventing a second stroke in people with nonrheumatic atrial fibrillation and recent cerebral ischaemia. Nonrheumatic atrial fibrillation (NRAF) is a heart rhythm disorder commonly found in patients who have had a stroke. Patients with NRAF have an irregular heart beat and this can cause the formation of a blood clot in the left atrium of the heart . This clot may break away and block a cerebral artery causing a stroke. Patients who have had a stroke in the presence of NRAF have a high risk of another stroke. Anticoagulant drugs, such as warfarin, make the blood 'thinner' and prevent the formation of blood clots and hence could prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this complication could offset any benefits. This review identified two trials in which patients with NRAF who had a stroke were treated with anticoagulant therapy. These studies show that anticoagulants safely reduce the risk of recurrent stroke by two‐thirds, despite a higher chance of major extracranial bleeds. There was no increased risk of intracranial bleeds.

Anticoagulants for preventing recurrence following presumed non‐cardioembolic ischaemic stroke or transient ischaemic attack

Most strokes are due to a sudden blockage of an artery in the brain (this type of stroke is called an ischaemic stroke). In most ischaemic strokes, the blockage is caused by a blood clot. In patients with an irregular heart rhythm (atrial fibrillation), anticoagulant drugs, such as warfarin, prevent such clots forming and prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this harmful effect could outweigh any benefits in patients with a normal heart rhythm. This review identified 11 trials, involving 2487 participants who had had a stroke (and also had a normal heart rhythm), of anticoagulants to prevent further strokes. There was good evidence that anticoagulants could cause serious bleeding, and there was no evidence that, in such patients, anticoagulants were of benefit in the prevention of further strokes. Other trials have shown that, in a person with a normal heart rhythm who has had an ischaemic stroke, antiplatelet drugs such as aspirin are a safe and effective way to reduce the risk of further strokes and heart attacks.

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Summaries for consumers

Vitamin K antagonists versus antiplatelet therapy after transient ischaemic attack or minor ischaemic stroke of presumed arterial origin

People who have a stroke due to a blockage of an artery have a higher risk of having another possibly fatal stroke, or a heart attack. Treatment with antiplatelet drugs (like aspirin) definitely reduces this risk. Blood thinning treatment (anticoagulation by vitamin K antagonists) was believed to provide added protection. We reviewed eight trials involving 5762 participants that compared anticoagulants with antiplatelet agents for preventing recurrent stroke and found no benefit of low intensity anticoagulation over aspirin, and an increased risk of bleeding with high intensity anticoagulation.

Anticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischaemic attack

Anticoagulants are beneficial and safe for preventing a second stroke in people with nonrheumatic atrial fibrillation and recent cerebral ischaemia. Nonrheumatic atrial fibrillation (NRAF) is a heart rhythm disorder commonly found in patients who have had a stroke. Patients with NRAF have an irregular heart beat and this can cause the formation of a blood clot in the left atrium of the heart . This clot may break away and block a cerebral artery causing a stroke. Patients who have had a stroke in the presence of NRAF have a high risk of another stroke. Anticoagulant drugs, such as warfarin, make the blood 'thinner' and prevent the formation of blood clots and hence could prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this complication could offset any benefits. This review identified two trials in which patients with NRAF who had a stroke were treated with anticoagulant therapy. These studies show that anticoagulants safely reduce the risk of recurrent stroke by two‐thirds, despite a higher chance of major extracranial bleeds. There was no increased risk of intracranial bleeds.

Anticoagulants for preventing recurrence following presumed non‐cardioembolic ischaemic stroke or transient ischaemic attack

Most strokes are due to a sudden blockage of an artery in the brain (this type of stroke is called an ischaemic stroke). In most ischaemic strokes, the blockage is caused by a blood clot. In patients with an irregular heart rhythm (atrial fibrillation), anticoagulant drugs, such as warfarin, prevent such clots forming and prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this harmful effect could outweigh any benefits in patients with a normal heart rhythm. This review identified 11 trials, involving 2487 participants who had had a stroke (and also had a normal heart rhythm), of anticoagulants to prevent further strokes. There was good evidence that anticoagulants could cause serious bleeding, and there was no evidence that, in such patients, anticoagulants were of benefit in the prevention of further strokes. Other trials have shown that, in a person with a normal heart rhythm who has had an ischaemic stroke, antiplatelet drugs such as aspirin are a safe and effective way to reduce the risk of further strokes and heart attacks.

See all (22)

Terms to know

Brain
The part of the central nervous system that is contained within the skull (cranium).
Ischemia
Lack of blood supply to a part of the body. Ischemia may cause tissue damage due to the lack of oxygen and nutrients.
Systemic Circulation (Blood Circulation)
Systemic circulation is the part of the cardiovascular system which carries oxygenated blood away from the heart to the body, and returns deoxygenated blood back to the heart.
Transient
Temporary; not permanent.

More about Transient Ischemic Attack

Photo of an adult

Also called: Transient ischaemic attack, Transient cerebral ischaemia, Intermittent cerebral ischaemia, Transient cerebral ischemia, Temporary cerebral vascular dysfunction, Intermittent cerebral ischemia, Mini-stroke

See Also: Stroke

Other terms to know: See all 4
Brain, Ischemia, Systemic Circulation (Blood Circulation)

Related articles:
In an Emergency: Signs of a Stroke

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