Munson Health
 
Transient Ischemic Attack

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by Wood D

(TIA; Mini-Stroke)

 

Risk Factors

Certain chronic medical conditions can affect the health of your blood vessels. These conditions may increase your chances of TIA:
TIAs are more common in men than women in younger age groups. They are also more common in people age 45 years or older, with the highest risk between ages 60-80 years. Other factors that increase your chance for TIA include:
 

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor will carefully assess your blood pressure and nervous system. The main goal of tests or questions will be to determine your stroke risk.
Tests may include:
 

Treatment

A TIA places you at greater risk for having a stroke. The risk is actually highest in the first week after your TIA. Therefore, rapid treatment aims to decrease your risk of stroke. This can be done with lifestyle changes, medication, and surgery.

Lifestyle

Smokers must quit. Talk with your doctor about the smoking cessation programs.
People with diabetes, hypertension, and/or high cholesterol must make every effort to manage these conditions. It can be done with:
  • Regular exercise under the guidance of your doctor
  • Appropriate dietary changes—low in saturated fat, and rich in whole grains, fruits, and vegetables
  • Other lifestyle interventions, such as monitoring alcohol intake

Medications

The doctor may also prescribe medications to lower blood sugar, blood pressure, and cholesterol. This will help lower these risk factors.
To decrease the risk of clot formation your doctor may recommend antiplatelet agents such as aspirin.
If the blood clot came from your heart due to atrial fibrillation, anticoagulants may be prescribed.

Surgery

If you have at least a 70% blockage in your carotid artery (in your neck), doctors may recommend:
  • A carotid endarterectomy to remove the plaque deposits
  • Other less invasive procedures, such as intra-arterial stenting to widen an artery
These procedures have risks associated with them. Talk wth your doctor about your options.

Treatment of Underlying Conditions

If the cause of the TIA is a treatable condition, it must be promptly treated. Specific conditions that need further treatment include:
  • Atrial fibrillation
  • Severe anemia
  • Vasculitis
 

Prevention

To reduce your chance of TIA or stroke, take these steps:
 

RESOURCES

American Heart Association
http://www.heart.org

National Stroke Association
http://www.stroke.org

 

CANADIAN RESOURCES

Canadian Society for Vascular Surgery
http://canadianvascular.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

 

References


Amarenco P, Bogousslavsky J, Callahan A III, et al; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549-59.


FDA approves Pradaxa to prevent stroke in people with atrial fibrillation. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm230241.htm. Updated April 19, 2013. Accessed June 2, 2014.


Lutsep HL. MATCH results: implications for the internist. Am J Med. 2006;119:526.


NINDS Transient Ischemic Attack Information Page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/tia/tia.htm. Updated April 28, 2014. Accessed June 2, 2014.


Risk factors for stroke or transient ischemic attack. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 2, 2014. Accessed June 2, 2014.


Transient ischemic attack (TIA). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 27, 2014. Accessed June 2, 2014.


6/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Myint PK, Cleark AB, et al. Bone mineral density and incidence of stroke: European prospective investigation into cancer-norfolk population-based study, systemic review, and meta-analysis. Stroke. 2014 Feb;45(2):373-382.


6/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Imfeld P, Bodmer M, et al. Risk of incident stroke in patients with Alzheimer disease or vascular dementia. Neurology. 2013 Sep 3;81(10):910-919.

 

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