Symptoms of Transient Ischemic Attacks
— -- A TIA (Transient Ischemic Attacks) is an important warning sign that can happen before a major stroke occurs. The symptoms of TIA are similar to a stroke, but resolve quickly. Symptoms of TIA can include the following sudden symptoms:
· Weakness in an arm, hand or leg· Numbness on one side of the body· Loss or blurring of vision in one or both eyes· Difficulty talking or understanding speech· Imbalance, loss of coordination
By current definition, TIA symptoms resolve within 24 hours, but most last less than 90 minutes and they frequently reverse over several minutes. Because the symptoms go away, many persons dismiss the spell with potentially dangerous consequences.
Even health professionals need to be more aware of the significance of TIAs as one study found that one-third of TIA patients had no specific evaluations over the first month, the period of greatest risk.
A recent study showed that one in ten patients having a TIA went on to have a stroke over the next 3 months with over half occurring over the first two days. A lot can be done to prevent stroke in persons who have had a TIA, provided that they rapidly seek appropriate medical care.
· Some TIAs are related to narrowing of the large arteries in the neck (carotid arteries). Several well-done clinical trials show that an operation to remove the narrowing (carotid endarterectomy) significantly decreases the risk of stroke when done in appropriately selected patients by skilled surgeons. Studies are in progress testing the use of a balloon to widen the area of narrowing and the placement of a tube to keep the artery open (called a stent).
· Some TIAs or minor strokes can be associated with atrial fibrillation (an irregular beating of the upper chamber of the heart that can lead to blood clots to form). Several studies show that selected patients with atrial fibrillation benefit from treatment with a blood thinner (the anticoagulant warfarin). However, studies show that this is used in only about half of patients who might qualify to receive the drug.
· Those not requiring a blood thinner like warfarin may benefit from antiplatelet aspirin-like drugs.
· Diabetics who have had TIA benefit from lowering of blood pressure.
· Other risk factors for stroke in patients with TIA need to be identified and treated (including high blood pressure and in certain patients, elevated cholesterol).
· General lifestyle changes need to be initiated (smoking cessation, moderation of alcohol consumption, exercise)
· Rarer causes of TIA and stroke may need to be identified.
The person having a TIA needs to take the symptoms very seriously to take the steps necessary to lessen that chances of having a major stroke.
For more information about TIAs, visit:
The American Stroke Association http://www.strokeassociation.org/
National Stroke Association http://www.stroke.org/
Dr. Larry B. Goldstein is the director of the Duke Center for Cerebrovascular DiseaseHead, Stroke Policy Program at the Center for Clinical Health Policy Research atDuke University.