Any time blood flow to the brain is interrupted, you have a serious problem. In many cases, this is known as a stroke, and it can have life-threatening and long-term consequences. In some cases, the body’s natural anti-clotting properties are able to break up the clot that is blocking blood flow. This is known as a ‘transient ischemic attack’ or TIA.
TIAs are notable because symptoms, which are the same as those for a stroke, tend to resolve on their own, usually within an hour. However, experts warn that waiting around for that to happen can make the difference between life and death or long-term disability.
“The message that stroke neurologists and other physicians want to get out to the public is that there is really no difference between a stroke and a TIA with regard to how serious the event is,” says Dr. Eli Feen, a SLUCare neurologist. “Both of them represent the same underlying medical problem. We want to emphasize that a TIA does involve a blood clot that forms. Even though the symptoms got better because the blood clot got broken up and blood flow started up again to an area of the brain, the fact that a blood clot formed is a very serious matter that has to be investigated.”
Typical symptoms include sudden blindness (total or partial) in one or both eyes, numbness and/or weakness on one side of the face and body, slurred speech, difficulty using correct words, sudden unsteadiness, or incoordination of the limbs. Because these symptoms may indicate a serious stroke or a TIA, immediate medical attention is needed.
“The hospital can perform tests to see if this is stroke or TIA,” explains Nancy Jackson, stroke coordinator with the SSM Neurosciences Institute at DePaul Health Center. “There are new treatments to stop a stroke, but you must get to the hospital within two hours of the symptoms starting for the treatment to be used.”
Patients experiencing possible stroke symptoms are given a complete neurological exam, including CT or MRI imaging of the brain. Assessment of the heart and carotid arteries, which supply blood to the brain, also help determine cause and treatment.
“The risk of a TIA is that it increases the likelihood of a stroke with potentially devastating disability,” notes Dr. Michael Hatlelid, a neurologist and director of stroke services at Missouri Baptist Medical Center. “For example, a 65-year-old woman with a blood pressure of 150/95 and a history of diabetes who develops sudden weakness in an arm and leg, lasting for two hours and resolving, has a two-day stroke risk of 8 percent and a 90-day risk of 18 percent.”
Most patients who come to the emergency room with stroke symptoms are admitted to the hospital for more extensive evaluation and observation. Treatment and follow-up care is based on a variety of individual factors. “It does depend very much on the individual features of the particular patient, both what happened to them and what we found during our investigation,” Feen notes. “Some kind of blood thinner and cholesterol medication is very commonly used with stroke victims where the stroke was due to a blood clot that blocked off blood supply.”
Feen and other physicians also stress the importance of reducing future stroke risk through smoking cessation (which Feen calls the “single-most powerful step you can take”), as well as exercise, weight management and appropriate medical follow-up.