Transient ischaemic attack

A transient ischaemic attack (TIA) is caused by a temporary cut in blood supply to the brain, due to the partial blockage of an artery by a blood clot or debris. A TIA has the same symptoms as a stroke, but they are temporary and do not usually cause long-term brain damage.

A person who has had a TIA, or ‘mini-stroke’, is at greater risk of having a stroke or heart attack. Early identification of symptoms and a diagnosis from your doctor greatly reduces the chances of a major stroke.

TIA is an early warning for stroke
A stroke interrupts blood flow to an area of the brain. A blood clot could block a blood vessel or (more rarely) a blood vessel might break. Brain cells in the immediate area are starved of oxygen and die – without prompt medical treatment, the surrounding brain cells may also die.

A TIA has identical symptoms to a stroke, but these last for less than 24 hours and are followed by a full recovery. A TIA is a powerful warning that an area of the brain is being deprived of blood and that a stroke may follow in the next few hours, days, weeks or months. Urgent medical attention is needed.

Symptoms
The specific symptoms of a TIA depend on which areas of the brain are being deprived of blood. They can include:

• Visual problems, such as blurring or reduced vision in one or both eyes
• Numbness, weakness or paralysis of the face
• Numbness, weakness or paralysis in an arm or leg, on either or both sides of the body
• Difficulty speaking or understanding
• Dizziness
• Loss of balance
• Swallowing difficulties
• Severe headache or an unusual change in headache pattern
• Nausea
• Vomiting.

• Facial weakness – can the person smile; have their mouth or eyes drooped?
• Arm weakness – can the person raise both arms?
• Speech difficulty – can the person speak clearly and understand what you say?
• Time to act – act FAST and call 000 immediately.

• High blood pressure
• Cigarette smoking
• Unmanaged diabetes
• High cholesterol levels
• Lack of regular exercise
• Overconsumption of alcohol, such as frequent binge drinking
• Obesity
• High fat diet, particularly saturated fats
• High salt diet, which can cause high blood pressure.

• If the TIA lasts for longer than 10 minutes
• If TIA symptoms include weakness and speech problems
• If the person is older than 60 years
• If the person has diabetes.

• Physical examination, including blood pressure measurement
• Blood tests
• Electrocardiogram (ECG) tests to check for abnormal heart rhythms
• Chest x-ray
• Computed tomography (CT) scan of the head
• Ultrasound scan of the carotid arteries
• Heart ultrasound (echocardiogram) to check for heart disease.

• Drugs, such as aspirin, to reduce the risk of blood clots forming in the blood
• The blood-thinning drug warfarin, if the blood clot was caused by heart problems such as atrial fibrillation (abnormal heart rhythms)
• Antihypertensive medication, if your blood pressure is too high
• Drugs to lower cholesterol, if your blood cholesterol is too high
• Surgery to remove the blockage inside an affected carotid artery (carotid endarterectomy). Sometimes, surgery is needed on both arteries.

• Stop smoking, since cigarette smoke narrows arteries and makes the blood ‘sticky’ and more likely to clot
• Switch to a low fat, low salt, high fibre diet
• Strictly limit your dietary intake of saturated fats to help reduce your blood cholesterol
• Maintain a healthy weight for your height
• Exercise regularly
• Limit alcohol to between one or two standard drinks per day
• Properly control diabetes.

• Always dial triple zero (000) to call an ambulance if you think someone is having a stroke or TIA
• Your doctor
• Emergency department of your nearest hospital
• Neurologist
• National Stroke Foundation Tel. (03) 9670 1000 or 1800 787 653

• A transient ischaemic attack (TIA) is a minor stroke and provides a powerful warning that a stroke may follow in the next few hours, days, weeks or months.
• A TIA has identical symptoms to stroke; however, these last for less than 24 hours and are followed by a full recovery.
• A TIA is a medical emergency.
• Treatment aims to prevent the person from experiencing a stroke and may include drugs and lifestyle changes.

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