Transient Ischaemic Event

A Transient Ischaemic Attack (TIA)—sometimes called a mini-stroke or transient ischaemic event—is a temporary episode of neurological dysfunction caused by a brief reduction in blood flow to part of the brain, spinal cord, or retina. Unlike a full stroke, the blockage resolves quickly, so there is no lasting brain damage. However, it is an important warning sign that a person is at high risk of a future stroke.

🔹How it Occurs

A TIA happens when blood supply to the brain is briefly interrupted, typically due to:

• A blood clot (thrombus or embolus) temporarily blocking a cerebral artery.

• Atherosclerosis (narrowing of arteries) reducing blood flow, especially in the carotid arteries.

• Small vessel disease (tiny arteries in the brain getting blocked).

• Less common causes include heart rhythm disturbances (like atrial fibrillation, which can send clots to the brain), arterial dissections, or inflammatory vessel diseases.

The blockage lasts only a few minutes to hours (by definition, symptoms resolve within 24 hours, but usually much sooner).

🔹 Symptoms

TIA symptoms mimic those of a stroke but are temporary:

• Sudden weakness or numbness (often on one side of the body).

• Slurred speech or difficulty understanding words.

• Vision loss in one eye (amaurosis fugax) or double vision.

• Sudden imbalance, dizziness, or difficulty walking.

🔹 Treatment

Although symptoms resolve, treatment is urgent to prevent a major stroke. Management includes:

1. Immediate evaluation

   • Brain imaging (CT or MRI) to rule out stroke/bleeding.

   • Carotid ultrasound or CT angiography to check for arterial narrowing.

   • ECG/heart monitoring to detect atrial fibrillation.

2. Medication

   • Antiplatelets (e.g., aspirin, clopidogrel) to prevent clots.

   • Anticoagulants if atrial fibrillation is the cause (e.g., warfarin, DOACs).

   • Statins to reduce cholesterol.

   • Blood pressure control with antihypertensives if needed.

3. Surgical/procedural options

   • Carotid endarterectomy or stenting if severe narrowing of carotid arteries is found.

4. Lifestyle changes

   • Stop smoking, exercise regularly, manage diabetes, eat a heart-healthy diet, and reduce alcohol.

A TIA is a short-lived episode of reduced brain blood flow that mimics a stroke but leaves no permanent damage. It is caused by temporary blockage of a cerebral artery, most often due to a small clot or narrowed arteries. Treatment focuses on preventing a full stroke through urgent evaluation, medications, possible surgery, and risk factor modification.