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November 24, 2009
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Transient Ischemic Attack
(TIA, Mini-Stroke)

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Daniel Kulick, MD, FACC, FSCAI, and William C. Shiel Jr., MD, FACP, FACR

Doctor to Patient

Transient Ischemic Attack (TIA) Symptoms: A Trip to the ER

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Transient Ischemia Attack (TIA) is an EmergencyThe event

A 73 year old woman is vacuuming when her left leg becomes weak and she has difficulty standing. Her face and left arm become numb. She calls for her husband, who helps her to a chair, and even though the symptoms resolve within five minutes, they decide to go to the hospital. In the hospital parking lot, they debate whether they should go into the Emergency Department or just turn around and go home.

This woman has suffered a TIA, or transient ischemic attack, which is basically a stroke that resolves on its own. Since the right side of the brain controls the left side of the body (and vice versa), she suffered reversible damage to her right brain and that caused her left leg to get weak and also developed numbness on the left side.

After some discussion, the woman decides she wants to seek medical care, and she and her husband walk through the Emergency Department doors. The doctor and nurse take a medical history to find out what happened. All of the symptoms have resolved, so the next step is follow-up care. The healthcare team asks the patient if she has any of the known risk factors for stroke (which are the same for heart disease):


Top Searched Transient Ischemic Attack (TIA) Terms:

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Doctor to Patient

What is a transient ischemic attack (TIA)?

The primary role of the brain is to send signals to the body for motor function and through the five senses (sight, hearing, touch, smell, and taste), to receive signals and return the appropriate response. The brain processes information through conscious thought and unconsciously through nerve systems that control basic bodily functions, like heart rate, temperature control and balance.

For the most part, the brain is arranged so that the right side of the brain controls the left side of the body and the left side of the brain controls the right of the body. Vision is located in the back of the brain (occiput) and balance and coordination is located at the bottom of the brain (cerebellum). Blood supply to the brain comes from the carotid arteries that are located in the front of the neck and the vertebral arteries that run in the back of neck through small canals in the bony spine (vertebrae) of the neck.

When a portion of the brain loses its blood supply, it becomes oxygen deficient and can become damaged. The part of the body that the brain controls stops functioning. This is called a stroke or a cerebro-vascular accident (CVA). If the brain is able to regain its blood supply quickly, then the CVA symptoms may resolve; this is known as a transient ischemic attack (TIA).

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 get blocked and blood supply to a part of the brain is lost, or a blood vessel leaks blood into the brain (brain hemorrhage). Most commonly, 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).

Atherosclerosis or "hardening of the arteries" can cause fatty plaque formations in he blood vessel wall. The plaque can rupture and causes 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 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

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 a true stroke (CVA), as opposed to a TIA.



Next: What are the risk factors for transient ischemic attack (TIA)? »

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Transient Ischemic Attack (TIA, Mini-Stroke)

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