Transient Ischemic Attack (TIA, Mini-Stroke) - Causes

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What are the causes of transient ischemic attack (TIA)?

Loss of blood supply to portions of the brain can occur for a variety of reasons. A blood vessel can become blocked, and blood supply to a part of the brain is lost, or a blood vessel can leak blood into the brain (brain hemorrhage). Most commonly however, the blood vessel is blocked. The blockage can be caused by a blood clot that forms in the blood vessel (thrombosis) or it can be caused by a clot or debris that floats downstream (embolus).

Blocked blood vessels

Fatty plaque formation in the blood vessel wall is called atherosclerosis or "hardening of the arteries." Plaque can rupture and cause a small blood clot to form and occlude the blood vessel. Blockage can also occur when debris from narrowing of a carotid artery breaks off, and floats downstream to cause the occlusion. Sometimes, in people with an irregular heart beat called atrial fibrillation, small blood clots can be formed within the heart and travel to the brain to cause the obstruction.

Picture of Carotid Artery Disease and Plaque Buildup
Picture of Carotid Artery Disease and Plaque Buildup

Picture of Carotid Artery Disease and Plaque Buildup

Brain hemorrhage or bleeding in the brain can be due to an aneurysm, a weak spot in a blood vessel that ruptures and spills blood into the brain tissue, or it may be due to spontaneous bleeding caused by poorly controlled hypertension (high blood pressure). Such bleeding more commonly results in the irreversible damage of a stroke, as opposed to a TIA.

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Comment from: Brittney, 25-34 Female (Patient) Published: July 09

I started having bad headaches which lasted about 3 weeks and then I had a sudden seizure. Emergency room (ER) found no cause and put me on seizure medications and sent me home. A week later I had another seizure. ER found no cause and sent me home. With each seizure I was dizzy, vision blurred, and was nauseated. But a few days after that I was getting ready for bed and my left eye suddenly went black. No numbness or anything like that, just went dark and I felt confused. But it came back after a few minutes. I went to bed and the next morning had another seizure. I went to the ER and they did an MRI and found I was having transient ischemic attacks (TIAs) due to a blood disorder that causes thick blood. I was given blood thinners and a higher dose of seizure medicines. This was all in the last 3 weeks. I'm 26 and have ulcerative colitis but otherwise in descent health. I have to lose weight but who doesn't, and now today I am having extreme pain in my shoulder if I use my arm in any way.

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Comment from: Pat_n_Tex, 65-74 Female (Patient) Published: November 05

I have had at least 3 transient ischemic attacks (TIAs) in last 3 years, each time lasting longer than the previous one. I have no risk factors, my blood pressure (BP) is normally around 110/64, lipids are great, I weigh 160 at 5 ft. 7 in., and have very good fasting blood sugar. I'm a post liver transplant patient of almost 10 years, on Neoral, Myfortic, thyroid, and 5 mg Ambien. I started taking 81 mg aspirin QD after second TIA, for which symptoms were fractalized vision peripherally, couldn't recognize speech on TV news, and couldn't read. It lasted around 20 minutes and I went to the emergency room (ER). CT scan was normal so I was told nothing was wrong, to go home. I saw a neurologist next week and MRI was ordered, which showed evidence of ischemic attacks, several, as well as a small tumor on pituitary. Latest attack came 2.5 years later, with 90% loss of vision in one eye while jogging. Everything in that eye became very dark with just a crack of light at extreme lower vision field. At ER, BP was slightly high for me, at 138/78, but within normal limits. I won't take Plavix but am continuing aspirin and am going to start nattokinase soon. I haven't been able to get MRI report of last ER visit but on progress notes of what I could obtain, it reported MRI/MRA 'unremarkable'. It could be a case of some radiologists being more skilled than others.

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