A transient ischemic attack (TIA), often referred to as a “ministroke,” occurs when part of the brain experiences a temporary lack of blood flow. This causes stroke-like symptoms that usually resolve within 24 hours.
The main difference between a stroke, which is also when there is a blockage of blood flow to the brain, and a TIA is that the symptoms of a TIA almost usually resolve themselves within a short period of time (a few hours to 24 hours).
On the other hand, the symptoms and complications of a stroke can be more permanent. This is because, with a TIA, the blockage in the blood vessel usually resolves itself.
However, since ministroke and stroke symptoms are nearly identical, it is best to seek emergency medical attention if you experience any of them.
Knowing the signs of a ministroke can help you get the treatment you need as early as possible.
Because the symptoms of a ministroke and actual stroke are so similar, it’s almost impossible to tell if you are dealing with one or the other until you’re medically evaluated.
One key factor to both sets of symptoms is that they happen suddenly.
- numbness or weakness in your face, arms, or legs (especially if that numbness is on one side of the body)
- sudden confusion
- trouble speaking
- trouble comprehending others
- trouble seeing
- trouble walking
- loss of balance
- lack of coordination
- a severe headache that doesn’t seem to have a cause
- difficulty swallowing (dysphagia)
- facial droop
If you or someone nearby suddenly starts experiencing any of these symptoms, call 911 or local emergency services, or go to the nearest emergency room as soon as possible.
Blood clots are the leading cause of ministrokes.
When there’s a clot in an artery that’s connected to the brain, blood can’t flow as freely as it needs to, which means the brain doesn’t get the oxygen it needs to work properly.
In a ministroke, these clots are usually temporary and are reabsorbed quickly, restoring proper blood flow.
Occasionally, fatty material in the artery (plaque) or an air bubble can cause a ministroke. Rarely, a small amount of bleeding in the brain (hemorrhage) can cause a ministroke.
The risk of blood clots goes up with age, since the older we get, the narrower our blood vessels get.
Other factors that can increase the likelihood of experiencing a blood clot include:
- high blood pressure (hypertension)
- narrowed arteries caused by plaque buildup (atherosclerosis) in or around the brain
- high cholesterol
High blood pressure is a major risk factor of both ministroke and stroke.
Over time, untreated high blood pressure can damage the inner walls of the arteries, resulting in atherosclerosis. This plaque buildup can rupture and lead to blood clots in these arteries. These abnormalities can lead to a ministroke and stroke.
If you’ve received a high blood pressure diagnosis from a doctor, it’s important to keep track of your blood pressure on a routine basis.
Additional risk factors for stroke fall into two categories: risk factors
While having one or more of these risk factors does not immediately mean you will have a stroke or ministroke, it’s important for you and your doctor to keep an eye on any preexisting conditions.
Risk factors you can control
- Smoking. The nicotine and carbon monoxide in cigarette smoke can harm the cardiovascular system, greatly increasing the risk of stroke.
- Diabetes. Untreated type 1 and type 2 diabetes increases the risk of stroke.
- Eating a high fat diet. Eating a lot of foods high in saturated fat and trans fat (e.g., lots of red meat, fried foods, and fast food) can raise your cholesterol, which in turn can raise your risk of stroke.
- Lack of physical activity. Not getting enough exercise can raise the risk of stroke.
- Obesity. Obesity can increase the risk of developing other conditions such as diabetes and high cholesterol, which in turn increase the risk of stroke.
Risk factors you can’t control
- Age. While the risk of stroke increases as we age, it’s still possible for younger people to have a stroke.
- Family history. If others in your family have had a stroke, especially before age 65, your risk of having one is increased.
- Race. African Americans have a
higher riskof stroke than other racial groups.
- Sex. Females have a higher risk of stroke than males due to certain factors such as pregnancy, a history of preeclampsia or gestational diabetes, oral contraceptive use, and postmenopausal hormone therapy.
While there may be some risk factors you can’t control, you can take the following precautions to lower your risk:
- If you smoke, quit smoking. Consider reaching out to a healthcare professional to create a quit plan.
- Avoid secondhand smoke when possible.
- Eat a nutrient-rich diet with lots of fruits, vegetables, and whole grains.
- Maintain a moderate weight.
- Exercise regularly.
- If you drink, limit your alcohol intake.
- Avoid using illegal drugs.
- Limit your fat intake, especially saturated and trans fats.
- If you have diabetes, high cholesterol, high blood pressure, or another underlying health condition, work with your healthcare team to manage it and find a treatment that works best for you.
The symptoms of a ministroke can last as briefly as a few seconds. By definition, ministrokes last for fewer than 24 hours.
Often, the symptoms may be gone by the time you get to a doctor. Your symptoms may not be present while a doctor evaluates you, so you have to describe the event after your symptoms have disappeared.
Duration aside, symptoms of a ministroke are the same as symptoms of an ischemic stroke. An ischemic stroke is the most common type of stroke.
Even if your symptoms dissipate or disappear before you get to your doctor or the emergency room, it’s essential to let the medical team know what happened.
Symptoms that come on suddenly and without warning could signify a stroke or ministroke. One helpful way to remember what to look out for is to think about the word “FAST”:
|FAST||Sign of stroke|
|F for face||If you notice a droop or uneven smile on a person’s face, this is a warning sign.|
|A for arms||Arm numbness or weakness can be a warning sign. You can ask the person to raise their arms if you’re unsure. It’s a warning sign if the arm drops down or isn’t steady.|
|S for speech difficulty||Ask the person to repeat something. Slurred speech can indicate that the person is having a stroke.|
|T for time||Act fast if someone is experiencing stroke symptoms. Get immediate medical help.|
Call 911 or local emergency services if you or someone around you has any of these symptoms.
A ministroke doesn’t typically lead to permanent brain damage, but you still need an urgent medical examination if you have symptoms of a ministroke.
The only way to tell the difference between a ministroke and a stroke is by having a doctor look at an image of your brain with either a CT scan or an MRI scan.
If you’ve had an ischemic stroke, it’s likely that it won’t show up on a CT scan of your brain for 24 to 48 hours. An MRI scan usually shows a stroke sooner.
In evaluating the cause of the ministroke or stroke, a doctor will likely order an ultrasound to see whether there’s significant blockage or plaque in your carotid arteries.
You’ll also need an echocardiogram to look for blood clots in your heart or a communication between the two sides of the heart, called a PFO.
The doctor will also take an electrocardiogram (ECG or EKG) and may take a chest X-ray.
If the doctor believes you’ve had a cryptogenic stroke, which means they can’t quite determine the cause, a
This involves inserting a probe through the esophagus to provide a clearer image of the heart.
Treatment for ministrokes focuses on starting or adjusting medications that improve blood flow to the brain.
It also requires identifying abnormalities that your doctor can fix to reduce your risk of future ministrokes or strokes.
Treatment options include medications, medical or surgical procedures, and lifestyle changes.
Antiplatelet drugs make your platelets less likely to stick together to prevent blood clots. These medications include:
- clopidogrel (Plavix)
- prasugrel (Effient)
- aspirin-dipyridamole (Aggrenox)
These medications prevent blood clots by targeting proteins that cause clotting, rather than targeting the platelets. This category includes:
- warfarin (Coumadin)
- rivaroxaban (Xarelto)
- apixaban (Eliquis)
If you’re taking warfarin, your doctor will closely monitor you with blood tests to make sure you have the correct dosage.
Drugs such as rivaroxaban and apixaban don’t require monitoring.
Minimally invasive carotid intervention
This is a surgical procedure that involves accessing the carotid arteries with a catheter.
The catheter is inserted through the femoral artery in your groin. A doctor uses a balloon-like device to open clogged arteries. They’ll place a stent or small wire tube inside the artery at the point of narrowing to improve blood flow to the brain.
You may need surgery to prevent future strokes. If you have a severe narrowing of the carotid artery in your neck and aren’t a candidate for a carotid angioplasty and stenting, your doctor may recommend a surgery called a carotid endarterectomy.
In the procedure, your doctor clears the carotid arteries of fatty deposits and plaques. This can reduce the risk of another ministroke or a stroke.
Lifestyle changes can reduce your risk of future ministrokes or strokes. Sometimes, these changes are needed alongside medication or procedures.
These lifestyle changes include:
- losing weight, if your doctor recommends it
- eating more fruits and vegetables
- reducing your intake of fried or refined sugar foods
- getting enough sleep
- reducing stress
- improving management of other conditions you may have, including diabetes, high blood pressure, and high cholesterol
The symptoms of a ministroke are almost identical to the symptoms of an actual stroke. However, the complications of a ministroke often fade after only a few hours, but they can be a sign of an impending stroke.
If you or someone near you seems to be experiencing the symptoms of either a ministroke or stroke, the best thing to do is call 911 or get to an emergency room immediately.
While the symptoms of a ministroke may be short term, they do increase the likelihood of having a stroke.
Understanding the symptoms, as well as your risk level for a ministroke, can help you stay prepared.