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Transient ischaemic attack (TIA)

What you need to know

  • A transient ischaemic attack (TIA) happens when the blood supply to your brain is blocked temporarily. The signs are the same as for a stroke, but they disappear within a short time. Often, they are only present for a few minutes.
  • After a suspected TIA, your doctor will do tests to provide a diagnosis and decide what treatment you need.
  • You must not drive for two weeks after a TIA. If you have a commercial driving licence, you must not drive for four weeks.
  • After a TIA, your risk of stroke is higher. Stroke can lead to death or disability. A TIA is a warning that you may have a stroke and is an opportunity to act to prevent this happening. With investigation and treatment, the risk of stroke following a TIA can be reduced by up to 80 percent.
  • A TIA should never be ignored. Call 000 immediately if you think you may be having a TIA, even if the signs go away and you feel better.

What is a TIA?

Blood is carried to your brain by blood vessels called arteries. Blood carries oxygen and nutrients for your brain cells. If the blood supply to your brain is blocked, your brain cells will die.

A transient ischaemic attack happens when the blood supply to your brain is blocked temporarily. When the blood supply is stopped, the brain cells in the area start dying, and you experience signs that something is wrong.

If the blockage clears and the blood supply starts again, the brain gets the oxygen and nutrients it needs and the signs disappear. This makes a TIA different to a stroke, where the brain cells die and your brain is permanently damaged.

Transient ischaemic [is-key-mick] attack is often shortened to ‘TIA’.

After a TIA, your risk of stroke is higher. Stroke can lead to death or disability. A TIA is a warning that you may have a stroke and an opportunity to prevent this from happening.

Signs

A TIA should never be ignored. The risk of stroke is highest in the first few hours and days after a TIA. You should call 000 immediately even if the signs go away and you feel better.

The FAST test is an easy way to remember the most common signs of stroke and TIA.

The signs are the same as for a stroke, but they completely disappear within a short time. Often, they are only often present for a few minutes.

The signs can be different for different people, depending on which part of the brain is affected.

There can be other signs, such as:

  • Numbness, clumsiness, weakness or paralysis of the face, arm or leg on one or both sides.
  • Dizziness (in particular ‘head spins’), loss of balance or an unexplained fall.
  • Loss of vision in one or both eyes.
  • Headache, usually severe and sudden.
  • Difficulty swallowing.
  • Nausea or vomiting.

It is important to make your family and friends aware of the signs of stroke and the need to call 000 immediately.

Recognise stroke: think F.A.S.T. F: Has their FACE drooped? A: Can they lift both ARMS? S: Is the SPEECH slurred and do they understand you? T: Call 000, TIME is critical. If you see any of these symptoms, act FAST. Call 000

 

Tests

Your doctor will want to know about your signs – what they were, how long they lasted and whether you have had them before. This will help distinguish between a TIA and other possible causes.

Your doctor will do a series of tests. These vary from person to person and may 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.

A brain scan is used to decide if you have had a TIA, a small stroke (with no ongoing impacts) or something that ‘mimics’ a TIA. There are other conditions that mimic TIA, so expert review is needed to distinguish TIAs from these other conditions.

If you have had a TIA, your scan will not show any signs of recent brain injury.

Imaging of the arteries

Arteries carry blood from the heart to the brain. Tests can see how the blood flows through the arteries, as damaged or blocked arteries in the neck can cause TIA. This is done in a variety of ways including ultrasound, CT angiogram or magnetic resonance angiogram.

Blood pressure check

After an initial check of your blood pressure, you may need it measured regularly.

Heart tests

 An electrocardiogram (ECG) tests for abnormal heart rhythm. Everyone suspected of having had a TIA should have an ECG. Atrial fibrillation (AF) is a heart condition in which your heart beats out of rhythm. Atrial fibrillation increases your risk of stroke, so testing for atrial fibrillation is very important after a TIA.

You may also need to wear a Holter monitor for 24 hours or longer. This checks your heart rhythm over an extended period of time. Your doctor may also order an echocardiogram (cardiac echo or ECHO) which is an ultrasound test that looks at the structures of the heart, as well blood flow within the heart.

Blood tests

 These tests are used to check your health. Blood tests can cover:

  • Cholesterol (fasting lipids)
  • Blood sugar levels
  • How well your kidneys work
  • The way your blood clots

Your doctor will discuss your test results with you so you have a better understanding of what has happened and what you need to do. Your doctor will make a plan for follow up, including referrals and appointments. You may need to go back to the hospital for further tests. Your doctor may refer you to a specialist. It is important to go to these appointments, even if you are feeling better.

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 might be criminally liable if you have an accident. Also, your insurance may not cover you. If you are unsure, check with your doctor and with the licensing authority in your state.

The rules about driving are different for different medical conditions, which means it is important to have it confirmed by your doctor that you have had a TIA.

For more information contact your State licensing authority.

Download

Download this resource Transient ischaemic attack – Signs, treatment and reducing your risk (PDF 2.55 MB)