Transient ischaemic attack (TIA)

What is a stroke?

A stroke is when blood can’t get to all parts of your brain. Blood carries oxygen and nutrients for your brain cells. If blood can’t get through, your brain can be injured.

Transient ischaemic attack (TIA) explained

A transient ischaemic attack (TIA) is caused by a temporary cut in blood supply to the brain, due to the partial blockage of an artery by a blood clot or debris. A TIA has the same symptoms as a stroke, but they are temporary as the clot naturally dissolves or is dislodged from the blockage. While it is sometimes called a mini stroke, a TIA does not usually cause long-term brain damage.

A person who has had a TIA is at greater risk of having a stroke or heart attack. Early identification of symptoms and a diagnosis from your doctor greatly reduces the chances of a major stroke.

Signs of a stroke

The F.A.S.T. test is an easy way to remember the most common signs of stroke. The signs are exactly the same for TIA.

• Face. Check their face. Has their mouth drooped?
• Arms. Can they lift both arms?
• Speech. Is their speech slurred? Do they understand you?
• Time is critical. If you see any of these signs call triple zero (000) straight away.

There can be other signs too:

• Your face, arm or leg can be numb, clumsy, weak or paralysed. This can be on one or both sides of your body
• Feeling dizzy, losing balance or falling over for no reason
• Losing your vision. This can be in one or both eyes
• Headache, usually severe and sudden
• Trouble swallowing
• Nausea and vomiting.

If you have any of the signs of stroke, call triple zero (000) straight away. Even if you aren’t sure, or the signs only last for a few minutes, call triple zero (000).

Causes

A stroke risk factor increases your risk of having a stroke.

Stroke risk factors include:

• High blood pressure
• High cholesterol
• Diabetes
• Atrial fibrillation
• Smoking
• Not moving enough
• Unhealthy eating
• Being overweight
• Drinking alcohol.

Medical problems can also cause strokes:

• Weak or tangled arteries in the brain
• A hole in the heart
• Heart problems.

These things increase women’s risk of having a stroke:

• Taking the contraceptive pill
• Taking hormone replacement therapy
• Being pregnant.

Your doctor will talk with you about your risk factors and medical problems. They will let you know if you need treatment. They will talk with you about what you can do to lower your risk of stroke.

Tests

Your doctor will want to know about what happened and how you felt when the TIA happened. They’ll ask about:

• the signs you noticed
• how long they lasted
• whether you’ve had them before.

Your doctor will refer you for one or more tests to find out more.

Tests vary from person to person. Some of them include:

• Brain scans. Computerised tomography (CT scan) or magnetic resonance imaging (MRI) take detailed pictures of your brain. After a suspected TIA, everyone should have a brain scan. If you have had a TIA, your scan will not show any signs of recent injury to the brain.
• Imaging of the arteries. Ultrasound, CT angiogram or MRI show how the blood flows through the arteries.
• Heart tests. An electrocardiogram (ECG) tests for abnormal heart rhythm. After a suspected TIA, everyone should have an ECG. You may also need to wear a Holter monitor for 24 hours or longer. Your doctor may also order an echocardiogram.
• Blood tests. You may need cholesterol (fasting lipids), blood sugar levels, and tests to see how well your kidneys work and the way your blood clots.
• Blood pressure check. After an initial check of your blood pressure, you may need it checked regularly.

Your doctor will discuss your test results with you and make a plan for follow up. It is important to go to any appointments arranged by your doctor.

Medication

After a TIA, your doctor may prescribe:

• Blood pressure lowering medication
• Cholesterol lowering medication
• Blood thinning medication.

Always talk with your doctor before you:

• Stop taking a medicine
• Change how much you take.

Driving

You must not drive for two weeks after a TIA. If you have a commercial driving licence, you must not drive for four weeks. If you drive before this time, you may face criminal charges if you have an accident. Your insurance will not cover you.

The rules about driving are different for different medical conditions. Your doctor needs to confirm that you have had a TIA.

For more information, contact the licensing authority in your state.

Where to get help

If you see any of the signs of stroke, call triple zero (000) immediately. Even if you aren’t sure, or the signs go away, call triple zero (000).

• Your GP (doctor).
• Transient ischaemic attack – Signs, treatment and reducing your risk has more information about TIA. If you would like a printed copy, please contact StrokeLine.
• StrokeLine. StrokeLine’s allied health professionals provide advice on stroke prevention, treatment and recovery. StrokeLine is a free and confidential service. Call 1800 787 653 Monday to Friday 9am to 5pm, Australian Eastern Standard Time.
• Stroke Foundation