Transient ischemic attack (TIA)

Transient ischemic attack (TIA)

A TIA is a transient stroke, Transient ischemic attack (TIA). There is a temporary lack of blood supply to part of the brain. This can cause problems with speech, strength, or sensation of the face, arms, and legs.

A TIA is short, the complaints last a few minutes to a maximum of 24 hours. If the symptoms are present for longer, it is referred to as a stroke. A Transient ischemic attack (TIA) can occur at all ages, however, most people are over 65 years old. One in 3000 Dutch people gets a Transient ischemic attack (TIA), over 65 years that is even one in 500.

Men are slightly more likely than women. Without treatment, one in three people will have a stroke or cerebral infarction within 5 years of a TIA.

See also, Stroke Cerebro Vascular Accident

Symptoms of a Transient ischemic attack (TIA)

With a TIA, failure symptoms suddenly arise, because the function of part of the brain is deficient. These phenomena often last a few seconds to minutes, they can last for up to 24 hours. If they last longer, there is a stroke or CVA (cerebrovascular accident). Failure symptoms are for example:

  • blindness in one eye
  • cannot see anything on the right or left
  • double vision
  • have a crooked mouth
  • talking with double tongue
  • can no longer come up with the right words
  • choking on food or drinks
  • no more strength or feeling in an arm and/or leg
  • have lost the handlebars over the arms and legs
  • losing balance while walking

How does a Transient ischemic attack arise?

A Transient ischemic attack (TIA) is caused by a temporary lack of blood supply to part of the brain. The cause is often a blood clot that closes a blood vessel. The brain can only go without oxygen for a few minutes, after which it stops functioning and the symptoms of a Transient ischemic attack (TIA) develop.

Arteriosclerosis plays an important role in the development of these blood clots. Fats, calcium, platelets, and other materials build up on the inside of the blood vessels. This makes it irregular and the diameter of the blood vessel narrows. Blood clots easily detach in the blood vessel, which can get stuck in a narrowed blood vessel further on and close it off. The clot will disintegrate over time and the blood can flow through again.

If the closure is short, the symptoms will disappear again. The blood clots mainly form in the large vessels of the neck, but can also arise in the heart when the heart beats irregularly. The risk factors for getting a TIA are follows:

Risk factors for Transient ischemic attack (TIA)

  • smoking
  • diabetes mellitus
  • high blood pressure
  • overweight
  • high cholesterol
  • heart and other vascular diseases
  • excessive use of alcohol
  • predisposition in the family
  • the male gender
  • higher age

In young people who get a Transient ischemic attack (TIA), there may also be other causes that play a role:

  • inflammation of the blood vessels
  • a sudden tear in the inner wall of the blood vessels
  • a heart defect
  • a blood disorder that makes the blood more likely to clot
  • a metabolic disease that causes arteriosclerosis early (homocysteinemia)

See also, Heart attack is a Myocardial infarction

Is it serious and what can you expect?

The failure symptoms in a TIA are usually completely over within minutes and at most within 24 hours. You will not be left with brain damage or sequelae. A Transient ischemic attack is an important warning that the blood supply to the brain is threatened and the risk of a stroke is greater. One in three people with a TIA will have a stroke within 5 years. So take a Transient ischemic attack seriously and always contact your doctor so that measures can be taken to prevent such a stroke.

Neurologist

Usually, the doctor will refer you to a neurologist at short notice. The neurologist will listen to your story, ask you questions, and examine you neurologically. He will then arrange for investigations to identify all risk factors for a TIA.

Mapping risk factors

Your head will be scanned. It can be seen whether you may have had a stroke before, without having suffered from it. Your blood will be tested for diabetes, high cholesterol, or signs of vascular inflammation. A heart trace (ECG) will be made to see if there is an irregular heart rhythm and to see if there are problems with the blood supply to the heart itself. Your blood pressure will be measured. And finally, an ECHO (Doppler) examination of the neck vessels will be done to see if there is a serious narrowing of the carotid arteries.

Preventing a new Transient ischemic attack (TIA) and stroke

To prevent another Transient ischemic attack (TIA) or even a stroke as much as possible, you will be prescribed blood thinners. Usually, it concerns a children’s aspirin, possibly in combination with another blood-thinning medicine. Sometimes blood-thinning medicines are needed, for which you have to go to the thrombosis service for a check-up. When research has shown that there is diabetes, obesity, too high cholesterol, or too high blood pressure, these conditions will also have to be treated. Sometimes this is possible with a diet, but often this will also require medication. You should absolutely stop smoking.

Carotid artery surgery

If the ECHO (Doppler) examination of the neck vessels has shown that you have a severe narrowing of the neck vessels, surgery may be required. During this operation, the inside of the blood vessel is cleaned and the caked plaque of arteriosclerosis is removed. The blood vessel can then be flowed through normally again, and blood clots crumble less easily. This also reduces the risk of a stroke.

When to go to the doctor?

If you recognize the symptoms of a Transient ischemic attack (TIA) in yourself, you should contact your doctor the same day. The doctor will examine you and if necessary refer you to the neurologist in the hospital. Investigating why you had a TIA in good time and treating your risk factors can prevent you from having another Transient ischemic attack (TIA) or stroke. So take failure symptoms, even if they last briefly, seriously, and contact your doctor.

See also, Nose bleeding common in men than in women

What can you do about it yourself?

You can influence a number of risk factors for the development of a Transient ischemic attack (TIA) yourself in order to reduce the chance of getting a TIA. You can do this by:

  • Not to smoke. Tips to quit:
    • agree on a stop date with yourself
    • tell the people around you, they can support you
    • stop with someone else
    • remove everything related to smoking from home
    • take a smoking cessation course from home care or the GGD
    • ask your doctor for supportive nicotine patches or gum
  • Avoid Overweight A simple formula to calculate if you are overweight is to determine your Body Mass Index (BMI) or Quetelet Index: your weight in kg divided by your height squared. If the calculated number is more than 25, it is overweight. Tips to reduce obesity:
    • follow a healthy and varied diet
    • do this in consultation with a dietician or a slimming club
    • try to exercise more
  • Exercise for half an hour every day, walking, cycling, swimming or some other sport
  • Moderate the use of alcohol, a maximum of 2 drinks per day
  • To use healthy foods:
    • use products with poly saturated fatty acids such as diet margarine, oil with linoleic acid, walnuts, and oily fish
    • avoid products with a lot of cholesterol such as egg yolks, liver, kidneys and crustaceans, and shellfish
    • avoid products with a lot of saturated fat such as butter, margarine, fatty meat, sausage, cheese, whole milk products, fried products, pretzels, chips, biscuits, cake, and chocolate. If you do use them, choose the lean varieties
    • anything that is meat from an animal that runs (game), flies (poultry), or swims (fish) is best, but in moderation (maximum 80 grams per day)
    • eat fish twice a week and vegetarian once a week
    • moderate with the use of salt: add an as little salt as possible during cooking and baking and use fresh herbs or pepper to season the food
    • eat enough vegetables (200 grams) and fruit (2 pieces)
    • provide fiber-rich foods (whole wheat bread, whole-wheat pasta, muesli)
    • drink one and a half liters of fluids a day
  • To prevent stress and take time to relax:
    • build in moments of rest in the day
    • set your own goals that you can achieve
    • do relaxation exercises
    • get more exercise
    • don’t bottle up your feelings, talk about them with others
    • follow a course on dealing with stress via RIAGG or GGD

Not all risk factors can be influenced, such as predisposition in the family, male gender or age.

General advice and precautions

If you have a family history of cardiovascular disease, high blood pressure, diabetes, high cholesterol, or obesity, you have an increased risk of developing cardiovascular problems yourself, including a Transient ischemic attack (TIA) or a stroke. In consultation with your doctor, you can have it checked whether these extra risk factors are also present. Then pay extra attention to the above rules of life and avoid smoking, becoming too fat, or exercising too little. Prevention of arteriosclerosis is better than treating it afterward.

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