Transient Ischaemic Attack (TIA)

A transient ischaemic attack (TIA), sometimes called a “mini-stroke,” is a brief episode of stroke-like symptoms caused by a temporary interruption of blood flow to part of the brain, with symptoms fully resolving, usually within an hour. It is an important warning sign, as it significantly increases the risk of a full stroke in the following days.

• Sudden weakness or numbness of the face, arm, or leg, usually on one side of the body
• Sudden difficulty speaking or understanding speech
• Sudden vision loss or double vision
• Sudden dizziness or loss of coordination
• By definition, symptoms fully resolve, typically within minutes to an hour, and do not leave lasting damage, though this is only clear in hindsight — a TIA should be treated with the same urgency as a stroke at the time it is happening

• Caused by a temporary blockage of blood flow to part of the brain, most often by a small blood clot that then dissolves or moves on before causing permanent damage.
• Shares the same underlying risk factors as stroke: hypertension, diabetes, atrial fibrillation, smoking, high cholesterol, and older age.

• Diagnosed based on the history of sudden, focal neurological symptoms that resolved, together with assessment of cardiovascular risk factors.
• Since it is not possible to be certain a TIA (rather than a stroke, or another condition) is occurring at the time symptoms are present, anyone with these symptoms should be assessed urgently as if it were a stroke.
• Brain imaging and further tests (such as checks for irregular heart rhythm or narrowing of neck arteries) are used to look for the underlying cause and guide prevention of a future event.

Anyone experiencing symptoms of a TIA should seek emergency care immediately, in exactly the same way as for a stroke, since it is not possible to know at the time whether symptoms will fully resolve or represent an evolving stroke.

Urgent assessment, ideally within 24 hours of symptoms, allows rapid evaluation of the underlying cause and starting of preventive treatment, since the risk of a full stroke is highest in the days immediately following a TIA.

Long-term prevention includes antiplatelet medicine (such as aspirin), a statin to lower cholesterol, and control of blood pressure, diabetes, and other risk factors.

Any underlying cause identified, such as an irregular heart rhythm or significant narrowing of a neck artery, is treated specifically to reduce future stroke risk.

• Control blood pressure, diabetes, and cholesterol through regular monitoring and treatment.
• Avoid tobacco use.
• Seek immediate emergency care for any sudden weakness, speech difficulty, or vision change, even if it resolves quickly — treat it as a stroke until proven otherwise.
• Take preventive medicines consistently if prescribed following a TIA, as the risk of a subsequent full stroke is significant, particularly soon after the event.