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Emergency: requires immediate attention
Transient ischemic attacks
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Transient ischemic attacks

Contributors: Ross Hamilton MD, Christine Osborne MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


A transient ischemic attack (TIA) is a transient episode of acute-onset neurologic symptoms that localize to a specific vascular territory or fit a described stroke syndrome. TIAs tend to be brief, lasting on the order of minutes to hours. Patients with transient symptoms lasting hours that would have formerly been diagnosed with TIA are now being found with evidence of cerebral ischemia on MRI. When a patient develops sudden-onset focal neurologic symptoms that could be due to a TIA or stroke, emergent medical attention is required, as there is no way to predict whether symptoms will resolve, and life-saving acute therapies may be given under certain conditions (thrombolytics or thrombectomy).

The pathophysiology of TIAs is thought to be due to reversible episodes of focal brain ischemia caused by the same mechanisms as in acute ischemic stroke:
  • Cardioembolic disease (commonly atrial fibrillation)
  • Large vessel disease (commonly atherosclerotic disease of the carotid arteries or vertebrobasilar arteries)
  • Small vessel disease (lacunar stroke syndromes commonly due to long-standing hypertension and diabetes)
Risk factors for TIAs include aging and vascular risk factors (ie, hypertension, dyslipidemia, diabetes, long-standing smokers). Patients who are in a hypercoagulable state (due to malignancy, genetic disorders, or other hematologic disorders) are also at increased risk.

Common symptoms include hemi-weakness of the face, hand, arm, or leg, hemi-sensation loss, aphasia, dysarthria, dysphagia, dizziness, diplopia, monocular vision loss, and difficulty walking. Findings fit within a specific vascular territory or stroke syndrome.

Certain populations, such as children, are less likely to be affected; however, TIA / stroke should be considered in young patients with Moyamoya disease, congenital heart disease, bacterial endocarditis, sickle cell anemia, mitochondrial disease, or homocystinuria. Patients taking oral contraceptives or estrogen may be at a higher risk at a younger age.

Related topics: drug-induced stroke, cerebral stroke, cerebellar stroke


G45.9 – Transient cerebral ischemic attack, unspecified

266257000 – Transient ischemic attack

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Last Reviewed:03/19/2018
Last Updated:09/29/2021
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Emergency: requires immediate attention
Patient Information for Transient ischemic attacks
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Contributors: Medical staff writer


A transient ischemic attack (TIA) is similar to a stroke when an artery of the brain becomes blocked (blood clot, high blood pressure) and stops blood flow to the brain. During a TIA the clogged blood vessel clears and symptoms resolve within a few minutes, causing no permanent damage. A blood clot, or embolism, can cause symptoms that lasts hours.

While symptoms of a TIA and a stroke appear the same, a stroke can lead to permanent damage or death if not treated promptly. Because of the difficulty telling them apart, both require immediate medical attention.

Who’s At Risk

The following risk factors increase the likelihood of a TIA and stroke:
  • Prior TIA, blood clots, or family history of stroke
  • Increased age, usually over 40
  • African descent / black
  • High blood pressure over 110/75
  • High cholesterol
  • Obesity
  • Diabetes
  • Heart disease, atherosclerosis (fatty-plaque buildup in arteries)
  • Certain birth control pills

Other factors that have been found to increase risk of cardiovascular disease, TIA, and stroke:
  • Smoking
  • Inactive lifestyle
  • Excessive alcohol consumption
  • Unhealthy diet (high in fats, salt, sugar, etc.)
  • Illicit drug use

Signs & Symptoms

The symptoms of a TIA resemble a stroke and include:
  • Paralysis, weakness, numbness on one side of the body (arm, face, leg)
  • Slurred or incoherent speech
  • Blindness or double vision (one eye, both eyes)
  • Sudden intense headache
  • Imbalance or lack of coordination

The FAST way to remember how to check for TIA or stroke symptoms:
  • F (FACE WEAKNESS) – Is the face drooping on one side? Or uneven?
  • A (ARM WEAKNESS) – Do arms held out in front appear uneven? Is one falling?
  • S (SPEECH DIFFICULTY) – Is it hard to speak? Is speech slurred or nonsensical?
  • T (TIME) – Don't waste time. If you have any of these signs, however short they last, immediately go by ambulance to a stroke center.

Self-Care Guidelines

To reduce your risk of a TIA, follow these guidelines:
  • Stop cigarette smoking
  • Engage in physical activity for 30 minutes of moderate exercise most days of the week
  • Limit alcohol intake
  • Reduce salt, fat, and sugar intake
  • Talk to your health care provider about which birth control pills carry less risk

When to Seek Medical Care

If symptoms develop, even if they stop in a few minutes, go to the hospital or call an emergency number (911) immediately. Because quick treatment is life-saving, it is now recommended to go promptly by ambulance to a stroke center hospital.


Your health care provider will help you control your blood pressure, diabetes, weight, cardiovascular disease, and other medical conditions to reduce your chance of repeat TIA or stroke.

After your first TIA your health care provider may recommend some treatment to reduce the likelihood of another TIA. Antiplatelet drugs are used to prevent platelets in the blood from sticking together and forming a clot. Aspirin is the most commonly used anti platelet drug but your health care provider may also administer clopidogrel (Plavix).

Anticoagulants such as heparin (Coumadin) or warfarin (Jantoven) affect clotting proteins. Your health care provider may administer these drugs however they require close monitoring.

If you have a narrowed neck artery, your health care provider may suggest having a carotid endarterectomy in which fatty deposits and plaque are cleared from the carotid artery.
Copyright © 2023 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Transient ischemic attacks
A medical illustration showing key findings of Transient ischemic attacks : Dizziness, Aphasia, Ataxia, Diplopia, Extremities weakness, Numbness, Vertigo, Focal neurologic deficit
Copyright © 2023 VisualDx®. All rights reserved.