Transient ischemic attack
During a TIA, part of your brain does not receive enough blood. Although you usually don’t like it, treatment is necessary. A TIA is a warning: it is often a precursor to a much more dangerous stroke. How do you recognize a TIA?
The abbreviation TIA stands for transient ischemic attack. Transient means temporary or transient. Ischemia is the medical term for insufficient blood (supply). A TIA is also known as a transient stroke.
What is a TIA?
During a TIA, part of the brain receives too little blood. This means that there is not enough oxygen in a part of the brain, so that certain brain cells no longer work properly.
You then suddenly get so-called failure symptoms, such as a crooked mouth, an arm or leg that you cannot move or a reduction in your vision. These phenomena are temporary. They usually last 5 to 20 minutes, sometimes a few hours. 24 hours later, the symptoms have often disappeared.
Stroke, TIA, cerebral infarction, cerebral haemorrhage?
TIA and stroke are sometimes called in the same breath. In addition, there is cerebral infarction and cerebral hemorrhage. What are the differences and similarities?
Stroke is the collective name for both a cerebral infarction and a brain haemorrhage. A TIA is similar to a stroke. These three conditions initially lead to similar symptoms, namely loss of consciousness. As long as the doctor does not yet know what exactly is going on, it is therefore called a stroke.
With a TIA, the symptoms quickly disappear, so it is not a ‘real’ stroke. It could be the harbinger of a stroke. A stroke (also called: CVA, the abbreviation for cerebrovascular accident), can be a cerebral infarction or a brain haemorrhage. In a stroke, a blood vessel in the brain is blocked. In a brain haemorrhage, there is a blood vessel leak.
Symptoms TIA: failure symptoms
What you notice from a TIA depends on the area in the brain affected. For example, if the part that controls your legs does not get oxygen for a while, you lose the feeling in the legs. Various symptoms can occur, namely:
- Muscles in the face become paralyzed, causing the corner of the mouth to hang down or the face to skew.
- You no longer have feeling in one arm or leg or both.
- Difficulty speaking: not getting your words out, talking unintelligibly or using gibberish.
- Vision problems, such as blurred or double vision. You can also be blind in one or both eyes.
- Dizziness.
- Difficulty walking and keeping your balance.
Do you or someone close to you suffer from these symptoms? Immediately call your doctor or 112. A TIA can be a precursor to a much more serious stroke. For the same reason, also visit your doctor if the symptoms have already disappeared, preferably the same day.
Diagnosis
Based on the description of your symptoms, your doctor or family doctor will estimate whether you have had a TIA. If you suspect a TIA, you will be referred to the TIA service in the hospital. There you will undergo various tests in one day, namely a heart film, brain scan, chest X-ray and an ultrasound of the arteries in your neck. In this way, the specialist finds out what caused the TIA and excludes any other causes for the symptoms.
You will then receive advice and medicines from the specialist, usually a neurologist, to reduce the risk of another TIA or stroke.
Causes of temporary stroke
A TIA is caused by a narrowing or blockage in a blood vessel. A poor condition of the blood vessels increases the risk. As you get older, the blood vessels deteriorate. They can narrow, damage the walls of the blood vessels and cause blood clots to stick to them. Platelets and fats (cholesterol) clump together to form ‘plaque’. That’s called arteriosclerosis. A (piece of) clot can break loose from the plaque and get stuck elsewhere in a blood vessel, causing a blockage there.
Another possible cause is a heart rhythm disorder. An irregular heartbeat can cause clots to form in the heart. If such a clot ends up in the brain, you can get a TIA.
Risk Factors
Because everyone’s blood vessel quality deteriorates over the years, the risk of a TIA increases with age. In addition, there are other factors that increase the chance of narrowing or blocking of your blood vessels, namely:
- An unhealthy lifestyle, such as smoking, drinking too much alcohol, exercising little, being overweight, using drugs, eating unhealthy foods.
- High bloodpressure.
- High cholesterol.
- stress.
- Type 2 diabetes.
- Using certain hormones, for menopausal symptoms or as contraception.
Treatment TIA
Once you have had a TIA, you have a greater risk of another TIA or stroke. To prevent these, you need medication. Which one exactly depends on the cause of the TIA. In any case, you will be given anticoagulants. These prevent the formation of blood clots. In addition, you usually receive medication for high cholesterol and high blood pressure. The use of these drugs has reduced the risk of a stroke after a TIA in recent years from about 10 percent to about 3 percent per year.
Sometimes surgery on the carotid artery is required. If it is narrowed, the damaged spot is in some cases cleaned or replaced by a plastic tube (stent).
In addition to medication and possible surgery, you will also receive lifestyle advice. For example, stop smoking, moderate alcohol consumption, exercise for half an hour every day, eat a lot of vegetables and fruit, relax a bit and lose weight if necessary. You are no longer allowed to use products that contain the female hormone oestrogen.
Effects
Most people have no complaints from a TIA. You are not allowed to drive for the first two weeks after a TIA. Your neurologist or rehabilitation doctor will then check whether you can safely get back into the car.
The effect of the medication stops as soon as you stop taking it, so you will need medication for the rest of your life. One in three patients who had a TIA will have a stroke. In addition, you have an increased risk of other vascular diseases. That is why it is important to stay under control and to adjust your lifestyle if necessary.
