TIA – The Silent Stroke


A TIA, or Transient Ischemic Attack, is like a stroke and has symptoms like a stroke, but differs from a stroke in that it lasts a few minutes to no more than 24 hours. For symptoms lasting longer than a day, attacks are considered mini-strokes. TIA’s normally have no long-lasting effects and do not cause permanent problems.

TIA’s are sometimes called mini-strokes and many medical professionals view them as harbingers of a full stroke. In fact, about a third of all who suffer a TIA will eventually have a stroke, with about half having a stroke within a year of the TIA. Although many view them as warnings, they are also opportunities for patients to learn about and, as much as possible, implement lifestyle changes in an effort to forestall full strokes.

Symptoms of TIA’s are very similar to early symptoms of stroke, which I detailed in “I’m Having a Stroke!  What Do I Do?”  Of course, TIA’s can last just a few minutes and most are over within an hour.  Still, if one were to experience TIA symptoms, it is still best to call 9-1-1 immediately.  There is too much at stake to wait!

TIA’s have the same causal mechanisms as full strokes, so it is essential so seek medical advice as soon as possible after the attack, preferably during the attack, if possible.

Ischemic Attacks are primarly due to the build-up of plaque in cerebral arteries, This build-up narrows the arteries and oxygen-rich blood is prevented from reaching certain areas of the brain.  Attacks, then, are due to the death of brain cells.  This arterial plaque is known as atherosclerosis and is due to cholesterol-containing fatty deposits that build up over time.  Plaque has also been shown to contribute to the formation of blood clots, which also prevent blood from reaching brain cells.

So, with a little information about TIA’s how do we know who will and who will not have TIA’s?  What are the risk factors?  What can we control and what is beyond our control?

Risk Factors We Control:

There are several health-related and lifestyle-related risk factors we can control.  This list certainly isn’t comprehensive and the items on the list do not mean to imply we won’t have strokes, but we can reduce or mitigate the possibility of having a TIA or a stroke.


Health Conditions:


High Blood Pressure – The American College of Cardiology and the American Heart Association have released new guidelines defining high blood pressure.  They state that 130/90 is the target blood pressure for most and blood pressures above that level are in the hypertensive range.  There is much evidence linking strokes and high blood pressure.  Your doctor can assist you with determining what your ideal blood pressure should be, based on several factors.

High Cholesterol – Cholesterol has been shown to be instrumental in the formation of arterial plaque and it is important to reduce it to a normal range.  The ideal method to control cholesterol is dietary, but chemical intervention may be necessary on the advice of a doctor.

Cardiovascular Disease – This includes heart attacks, heart defects, heart ifections, or abnormal heart rhythms.

Carotid Artery Disease – The carotid arteries supply much of the blood to the brain, and the can become occluded (blocked) which can contribute to TIA’s and strokes.

Peripheral Artery Disease – The periphery artieries supply blood to the arms and legs and these vessels can become clogged by narrowing arteries or blood clots.

Diabetes – This increases the severity of atherosclerosis, as the disease increases the amount of fatty deposits in the blood.

Excess Weight – A Body Mass Index (BMI) of 25 or over in men and women could increase the likelihood of TIA’s or strokes.

Lifestyle Changes:


Cigarette smoking increases your risk of blood clots and raises your blood pressure.

Physical inactivity may increase your Body Mass Index (BMI), but engaging in 30 minutes of moderate-intensity exercise several times weekly helps reduce risk.

Poor nutrition, particularly eating too much fat and salt, increases your risk of a TIA and a stroke.

Heavy drinking increases the likelihood of a TIA or stroke.  Limit yourself to no more than two drinks daily if you’re a man and one drink daily if you’re a woman.

Use of illicit drugs.  Simple.  Avoid cocaine and all illicit drugs.

Use of birth control pills.  All oral contraceptives increase your risk of a stroke. Some are more risky than others. Confer with your doctor about the risk factors.


Risk Factors Over Which We Have No Control:


Family history: Your risk may be greater if a member of your family members has had a TIA or a stroke.

Age: Your risk increases as you get older, especially after age 55.

Sex: Men have a slightly higher chance of a TIA and a stroke, but more than half of deaths from strokes occur in women.

Prior Transient Ischemic Attack: If you’ve had one or more TIAs, you’re 10 times more likely to have a stroke.

Sickle Cell Disease: A stroke is a frequent complication of this inherited disorder. Sickle-shaped blood cells carry less oxygen and also tend to get stuck in artery walls, hampering blood flow to the brain. However, with proper treatment for sickle cell disease, you can lower your risk of a stroke.

Race: Black people are at greater risk of dying of a stroke, partly because of the higher prevalence of high blood pressure and diabetes among blacks.


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