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Concept
Transient ischemic attack
Summary
A transient ischemic attack (TIA), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. TIA causes the same symptoms associated with strokes, such as weakness or numbness on one side of the body, sudden dimming or loss of vision, difficulty speaking or understanding language, slurred speech, or confusion.
All forms of stroke, including TIA, result from a disruption in blood flow to the central nervous system. A TIA is caused by a temporary disruption in blood flow to the brain, or cerebral blood flow (CBF). The primary difference between a major stroke and the TIA's minor stroke is how much tissue death (infarction) can be detected afterwards through medical imaging. While a TIA must by definition be associated with symptoms, strokes can also be asymptomatic or silent. In silent stroke, also known as silent cerebral infarct (SCI), there is permanent infarction detectable on imaging, but there are no immediately observable symptoms. The same person can have major strokes, minor strokes, and silent strokes, in any order.
The occurrence of a TIA is a risk factor for having a major stroke, and many people with TIA have a major stroke within 48 hours of the TIA. All forms of stroke are associated with increased risk of death or disability. Recognition that a TIA has occurred is an opportunity to start treatment, including medications and lifestyle changes, to prevent future strokes.
Signs and symptoms of TIA are widely variable and can mimic other neurologic conditions, making the clinical context and physical exam crucial in ruling in or out the diagnosis. The most common presenting symptoms of TIA are focal neurologic deficits, which can include, but are not limited to:
Amaurosis fugax (painless, temporary loss of vision)
One-sided facial droop
One-sided motor weakness
Diplopia (double vision)
Problems with balance and spatial orientation or dizziness
Visual field deficits, such as homonymous hemianopsia or monocular blindness
Sensory deficits in one or more limbs and of the face
Loss of ability to understand or express speech (aphasia)
Difficulty with articulation of speech (dysarthria)
Unsteady gait
Difficulties with swallowing (dysphagia)
Numbness or weakness generally occur on the opposite side of the body from the affected hemisphere of the brain.
Official source
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