Transient ischemic attacks

iStock_000001549975XSmallA transient ischemic attack, or TIA, is a sudden localized blood deprivation in the brain that can produce problems such as weakness in the hand, face or leg; loss of vision in one eye, poor balance, slurred speech, or seeing double. It resembles a mini-stroke but it usually lasts only a few minutes and is all gone within 24 hours.

Most TIAs are due to cerebral emboli from atherosclerotic plaques in the arteries in the neck or, less often, from thrombi in a diseased heart. Some TIAs are due to a brief reduction in blood flow through stenosed arteries. Hypertension, atherosclerosis, heart disease, atrial fibrillation and diabetes mellitus predispose to TIAs. TIAs are most common in the middle-aged and the elderly
Symptoms and Signs

TIAs begin suddenly, last 2 to 30 min. or more (seldom > 1 or 2 h), then abate without persistent neurological abnormalities; consciousness remains intact throughout the episode. When TIAs last for hours, patients may have infarcts, seen on subsequent brain CT or MRI scans, even without persistent neurologic abnormalities. Symptoms are identical to those of stroke but are transient.

Patients may have several TIAs dailv or only two or three over several years. Symptoms are usuallv similar in successive carotid attacks but vary somewhat in successive vertebrobasilar attacks. Patients with TIAs are at a markedly increased risk of stroke and should be evaluated for possible causes on an urgent basis.

It has been found that within five years of a transient ischemic attack, 35 per cent of the patients suffer a full-blown stroke. Even more significantly 50 per cent of these have their stroke within one month of their first attack. Therefore secondary prevention by treatment with drugs that reduce blood-clotting or platelet adhesion or surgery is of immense value in order to avoid a full-blown stroke later.

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