Transient ischaemic attack overview

Overview

A transient ischaemic attack (TIA) is a temporary blockage of blood flow to part of the brain. It is often called a 'mini-stroke' because the symptoms are like a stroke but they go away within minutes to hours. A TIA is a serious warning sign that you may have a full stroke in the near future.

Yes, TIAs are fairly common. About 1 in 20 people over the age of 65 will have one at some point, and younger adults can also be affected.

TIAs are most common in older adults, especially those over 60. People with high blood pressure, diabetes, high cholesterol, or an irregular heartbeat (atrial fibrillation) are at higher risk. But anyone, including younger adults, can have a TIA.

Symptoms

Common symptoms

• Sudden weakness or numbness on one side of the face, arm, or leg
• Sudden confusion or trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden dizziness or loss of balance
• Sudden severe headache with no known cause

Symptoms in children

• Children may have the same symptoms as adults, such as sudden weakness or trouble speaking, but these are very rare in children.
• In children, TIAs can be caused by different conditions, such as heart problems or blood vessel disorders.

Symptoms in older adults

• Older adults may experience temporary confusion or forgetfulness that comes on quickly and goes away.
• They may also have brief episodes of dizziness or trouble walking without a clear reason.

Causes

Main causes

• A blood clot that forms elsewhere in the body (like in the heart or the carotid arteries) and temporarily blocks a small blood vessel in the brain.

Risk factors

• High blood pressure (hypertension)
• Smoking
• Diabetes
• High cholesterol
• Atrial fibrillation (irregular heartbeat)
• Being overweight
• Not being physically active
• Heavy alcohol use
• Family history of stroke or TIA
• Age (over 60)
• Carotid artery disease (narrowing of the neck arteries)

When to see a doctor

See a doctor urgently if:

• Call emergency services immediately at the first sign of any TIA symptoms, even if they go away.
• If symptoms have resolved but you suspect a TIA, go to your nearest emergency department or urgent care clinic the same day.

Book a routine appointment if:

• If you have been diagnosed with a TIA, it is important to have regular follow-up appointments to manage your risk factors.
• See your healthcare provider if you have any new symptoms or if your current symptoms change.

Diagnosis

Your doctor will take a careful history of what happened, do a physical and neurological exam, and run tests to look for blockages or risk factors.

Tests that may be done

• Imaging tests of the brain, such as a CT scan or MRI
• Ultrasound of the carotid arteries to check for narrowing
• Electrocardiogram (ECG) to check the heart rhythm
• Echocardiogram to look at the structure of the heart
• Blood tests to check for diabetes, high cholesterol, and other conditions

What to expect at your appointment

You will likely be seen in an emergency department or a specialist 'TIA clinic' quickly. The evaluation can take a few hours. If a TIA is confirmed, your doctors will start treatment to reduce your stroke risk. Don't worry – you will be guided through every step.

Treatment

Treatment for a TIA focuses on preventing a full stroke. It usually involves medications to reduce the risk of blood clots and control underlying conditions. Your doctor will create a plan tailored to your situation.

Self-care at home

• Stop smoking – ask your health service for support programs.
• Limit alcohol to recommended levels.
• Manage stress with relaxation techniques or counseling.
• Take all medications exactly as prescribed.

Medical treatments

Doctors typically prescribe one or more medications that prevent blood clots (called antiplatelet or anticoagulant medicines). They may also prescribe medicine to lower blood pressure, reduce cholesterol, or control diabetes. The specific choice of drugs depends on your individual risk factors and overall health.

When is surgery considered?

If tests show a significant narrowing of the carotid artery in your neck (carotid stenosis), you may need a procedure called carotid endarterectomy. This surgery removes the fatty deposits and helps prevent future clots. Your doctor will discuss whether this is right for you.

Living with this condition

After a TIA, you will need to manage your risk factors every day. This means taking prescribed medicines, checking your blood pressure if advised, and watching for any stroke symptoms. Most people can return to normal activities, but it's important to follow your doctor's plan.

Lifestyle tips

• Quit smoking (get support from your local health service).
• Limit alcohol to no more than 1-2 drinks per day (or less if advised).
• Maintain a healthy weight.
• Manage stress with exercise, hobbies, or talking to a counselor.
• Monitor your blood pressure and cholesterol as instructed.

Diet and exercise

Eat a heart-healthy diet: plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats (like olive oil). Limit salt, sugar, and saturated fats. Aim for at least 150 minutes of moderate exercise each week, such as brisk walking, swimming, or cycling. Always check with your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Having a TIA can be frightening. You may feel anxious about having a stroke, or you might feel stressed about making lifestyle changes. It is common to worry. Talk to your doctor if these feelings last or interfere with your daily life. Counseling or support groups can help.

Prevention

Yes, the risk of a TIA (and stroke) can be greatly reduced by controlling risk factors. This means keeping blood pressure, cholesterol, and blood sugar under control, not smoking, eating a healthy diet, staying active, and managing medical conditions like atrial fibrillation.

Complications

If left untreated

• A full stroke, which can cause permanent brain damage or disability
• Another TIA
• Increased risk of heart attack or other blood vessel problems

Long-term outlook

With prompt medical care and lifestyle changes, the outlook after a TIA is very good. Most people who take steps to reduce their risk never have a stroke. A TIA can be a wake-up call that helps you protect your health for the long term.

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