A transient ischaemic attack (TIA), commonly called a ‘mini-stroke’, is a temporary disruption of blood supply to part of the brain that causes neurological symptoms but resolves completely within 24 hours (typically within minutes to a few hours) without causing permanent brain injury. The underlying process is identical to an ischaemic stroke, but the blockage is either very small or clears spontaneously before permanent damage occurs.
Symptoms of a TIA mirror those of stroke: sudden weakness or numbness (typically one side of the face, arm, or leg), speech disturbance, vision problems, or dizziness. The FAST acronym (Face drooping, Arm weakness, Speech difficulty, Time to call 999) applies equally to TIA and stroke. Despite symptom resolution, a TIA carries approximately a 10% risk of full stroke within 2 days without treatment; urgent assessment and intervention can significantly reduce this risk.
In the context of cardiovascular disease, atrial fibrillation is a major cause of cardioembolic TIA and stroke, as clots forming in the left atrial appendage can travel to the cerebral arteries. Anticoagulation for AF is one of the most important interventions for preventing cardioembolic stroke and TIA. After cardiac arrest, thromboembolism including TIA and stroke may occur as a complication of the resuscitation process.
Anyone experiencing TIA symptoms should call 999 immediately. Assessment includes brain imaging (CT or MRI), echocardiography, carotid ultrasound, ECG, and blood tests. Treatment with antiplatelet agents, statins, blood pressure lowering, and, where appropriate, anticoagulation is started promptly.
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