Transient ischemic attacks (TIAs), also known as mini strokes, can be subtle, quick and mistaken for other conditions. Aaron Loochtan, DO, vascular neurologist at OhioHealth, shares the warning signs of a TIA, as well as the importance of early detection and intervention to prevent a future stroke.
“The term mini stroke can be very misleading because these events should be taken seriously,” says Dr. Loochtan. “TIAs indicate an underlying condition that needs to be evaluated by a neurologist.”
TIA warning signs and symptoms
Caused by a temporary lack of oxygen and blood flow to the brain, TIAs typically last only minutes and the symptoms, such as facial drooping, go away completely after the event. However, TIAs are often a warning sign that a stroke might be on the horizon. An estimated one in five people who experience a TIA will have a stroke within 90 days.
“The primary difference between a TIA and a stoke is that there’s no lasting damage or evidence of a TIA on MRI or CT imaging,” says Dr. Loochtan. “Because their symptoms completely resolve, many people think they don’t need to seek medical attention. However, it’s important to understand what caused the event so we can work to prevent a stroke in the future.”
Symptoms of a TIA are similar to a stroke and can include:
- Facial drooping
- Vision issues, such as temporary blindness or seeing double
- Difficulty speaking or slurring words
- Trouble understanding what people are saying or doing
- Inability to move your arm or leg on one side of your body
- Extreme dizziness or loss of coordination
- Lack of sensation
Because these symptoms can happen with many other medical conditions, they can be difficult to interpret. Dr. Loochtan explains that people often have more than one symptom during a TIA or stroke. In addition, he says it’s important to remember that stroke symptoms typically involve the loss of sensation or ability, versus an amplification of your senses, as with a migraine.
“Someone with a migraine will often experience aura, kaleidoscope vision and tingling,” says Dr. Loochtan. “Stroke patients frequently experience a blackening of their vision or lose the ability to move or speak.”
Who is at risk
Some people are at a greater risk for a stroke or TIA. In general, the chance you will have a stroke starts to climb as you age, particularly after you turn 60. People with a history of heart disease, cerebral vascular disease, sleep apnea, diabetes, high blood pressure and high cholesterol are also at risk. The same is true for those who smoke, use drugs or consume multiple alcoholic drinks per week.
When to seek help
When it comes to stroke, neurologists often say that “time is brain.” According to the American Stroke Association, every minute that passes without treatment can mean the loss of 2 million brain cells. Dr. Loochtan stresses that anyone experiencing stroke symptoms should take them seriously and call 911. The BE FAST acronym can help patients and their loved ones quickly identify the signs and symptoms of a stroke.
Balance (loss of balance or coordination)
Eyes (loss or changes in vision)
Facial drooping or numbness
Arm weakness on one side of the body
Speech difficulties or slurring of words
Time to call 911
“People with these symptoms sometimes wait at home in the hope that their symptoms will go away,” says Dr. Loochtan. “Early treatment gives patients a better chance of a full recovery, but time is the key.”
While treatment for a stroke can involve clot-busting medications or minimally invasive procedures to remove a blood clot, mini strokes typically do not require acute treatment because symptoms disappear. However, Dr. Loochtan explains that after a TIA patients should be referred to a specialized clinic or emergency deparment for a follow-up evaluation and preventive treatment when appropriate.
TIA and stroke prevention
To ward off TIAs and stroke, Dr. Loochtan says that if it’s good for your heart, it’s also good for your brain. For otherwise healthy people looking to lower their risk, he suggests regular exercise that elevates your heart rate and a healthy diet that includes lean protein, whole grains and healthy fats such as olive oil, as well as plenty of fresh fruits and vegetables.
For people with additional risk factors, including a history of heart or vascular disease, Dr. Loochtan says that, in addition to a healthy diet and exercise, it’s paramount that you manage any health conditions, including diabetes, sleep apnea and high blood pressure or cholesterol. He says if you smoke, now is the time to quit, and he also recommends limiting your alcohol consumption.
“I always tell my patients that it’s possible to reduce your stroke risk,” says Dr. Loochtan. “Lifestyle changes can have a big impact and knowing you’ve reduced your chance of a vascular event is priceless.”
