Transient ischemic attack
A transient ischemic attack (TIA) occurs when blood flow to a part of the brain stops for a brief time. A person will have stroke-like symptoms for up to 24 hours. In most cases, the symptoms last for 1 to 2 hours.
A transient ischemic attack is a warning sign that a true stroke may happen in the future if something is not done to prevent it.
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...

Causes
Video Transcript
Stroke - Animation
When blood flow to an area of your brain stops, it's serious. It's called a stroke, and will often cause permanent, debilitating damage to your brain and change your life. Let's talk about strokes. If blood flow to your brain is stopped for longer than a few seconds, your brain can't get blood and oxygen. Brain cells die, causing permanent damage. There are two types, ischemic stroke and hemorrhagic stroke. Ischemic stroke happens when a blood clot forms in a very small artery, or when a blood clot breaks off from another artery and lodges in your brain. Hemorrhagic strokes can happen when a blood vessel in your brain becomes weak and bursts open. High blood pressure is the number one risk factor for strokes. People with atrial fibrillation, when your heart rhythm is fast and irregular, diabetes, a family history of stroke, and high cholesterol are most at risk. You are also at risk for stroke if you are older than age 55. Other risk factors include being overweight, drinking too much alcohol, eating too much salt, and smoking. Symptoms of a stroke usually develop suddenly, without warning. You may have a severe headache that starts suddenly, especially when you are lying flat, often when you awake from sleep. Your alertness may suddenly change. You may notice changes in your hearing, your sense of taste, and your sense of touch. You may feel clumsy or confused or have trouble swallowing or writing. So, how are strokes treated? A stroke is a medical emergency. Immediate treatment might save your life and reduce disability. Call your local emergency number -- or have someone call for you -- at the first sign of a stroke. Most of the time, someone having a stroke should be in the hospital within three hours after symptoms first begin. If a doctor suspects you've had a stroke, the doctor will check for problems with your vision, movement, feeling, reflexes, and your ability to understand and speak. You may have several tests to check for blocked or narrowed arteries. If the stroke is caused by a blood clot, you'll be given a clot-busting drug to dissolve the clot. Treatment depends on how bad your stroke is and what caused it. But you will probably need to stay in the hospital for a few days. Besides clot-busting drugs, called thrombolytics, you may need blood thinners, medicine to control high blood pressure, and surgery to unclog one of your carotid arteries-which carry blood to the brain. After your stroke, treatment will focus on helping you recover as much function as possible, and preventing future strokes. Most people need stroke rehabilitation therapy. If you can return home, you may need help making safety changes in your home and to help you with using the bathroom, cooking, dressing, and moving around your home. After a stroke, some people have trouble speaking or communicating with others, and a speech therapist might help. Depending on the severity of the stroke, you may have trouble with thinking and memory, problems with your muscles, joints, and nerves, trouble going to the bathroom, and difficulty swallowing and eating. Therapies and support for you and your family are available to help with each of these problems. Your treatment will also focus on preventing another stroke. You may need to be on several medications to help prevent this. And, eating healthy and controlling problems like diabetes and high blood pressure can be very important.
A TIA is different than a stroke. After a TIA, the blockage breaks up quickly and dissolves. A TIA does not cause brain tissue to die.
The loss of blood flow to an area of the brain can be caused by:
- A blood clot in an artery of the brain
- A blood clot that travels to the brain from somewhere else in the body (for example, from the heart)
- An injury to blood vessels
- Narrowing of a blood vessel in the brain or leading to the brain
High blood pressure is the main risk for TIAs and stroke. Other major risk factors are:
High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...

Risk factors
A stroke occurs when blood flow to a part of the brain suddenly stops. A stroke is sometimes called a "brain attack or cerebrovascular accident. " I...
Read Article Now Book Mark Article- Irregular heartbeat called atrial fibrillation
Atrial fibrillation
Atrial fibrillation or flutter is a common type of abnormal heartbeat. The heart rhythm is fast and most often irregular.
ImageRead Article Now Book Mark Article - Diabetes
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
ImageRead Article Now Book Mark Article - Family history of stroke
- Being male
- High cholesterol
High cholesterol
Cholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol can increase your chance of getting heart...
ImageRead Article Now Book Mark Article - Increasing age, especially after age 55
- Ethnicity (African Americans are more likely to die of stroke)
- Smoking
- Alcohol use
- Recreational drug use
- History of prior TIA or stroke
People who have heart disease or poor blood flow in their legs caused by narrowed arteries are also more likely to have a TIA or stroke.
Poor blood flow in their legs
Peripheral artery disease (PAD) is a condition of the blood vessels that supply the legs and feet. It occurs due to narrowing of the arteries in the...

Symptoms
Symptoms begin suddenly, last a short time (from a few minutes to 1 to 2 hours), and go away. They may occur again at a later time.
The symptoms of TIA are the same as the symptoms of a stroke, and include:
- Change in alertness (including sleepiness or unconsciousness)
- Changes in the senses (such as hearing, vision, taste, and touch)
- Mental changes (such as confusion, memory loss, difficulty writing or reading, trouble speaking or understanding others)
- Muscle problems (such as weakness, trouble swallowing, trouble walking)
- Dizziness or loss of balance and coordination
- Lack of control over the bladder or bowels
- Nerve problems (such as numbness or tingling on one side of the body)
Exams and Tests
Often, the symptoms and signs of a TIA will have gone away by the time you get to the hospital. A TIA diagnosis may be made based on your medical history alone.
The health care provider will do a complete physical exam to check for heart and blood vessel problems. You will also be checked for nerve and muscle problems.
The doctor will use a stethoscope to listen to your heart and arteries. An abnormal sound called a bruit may be heard when listening to the carotid artery in the neck or other artery. A bruit is caused by irregular blood flow.
Tests will be done to rule out a stroke or other disorders that may cause the symptoms:
- You will likely have a head CT scan or brain MRI. A stroke may show changes on these tests, but TIAs will not.
Head CT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
ImageRead Article Now Book Mark ArticleBrain MRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
ImageRead Article Now Book Mark Article - You may have an angiogram, CT angiogram, or MR angiogram to see which blood vessel is blocked or bleeding.
Angiogram
An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain...
ImageRead Article Now Book Mark Article - You may have an echocardiogram if your doctor thinks you may have a blood clot from the heart.
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
ImageRead Article Now Book Mark Article - Carotid duplex (ultrasound) can show if the carotid arteries in your neck have narrowed.
Carotid duplex
Carotid duplex is an ultrasound test that shows how well blood is flowing through the carotid arteries. The carotid arteries are located in the neck...
ImageRead Article Now Book Mark Article - You may have an electrocardiogram (ECG) and heart rhythm monitoring tests to check for an irregular heartbeat.
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
ImageRead Article Now Book Mark ArticleHeart rhythm monitoring
A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.
ImageRead Article Now Book Mark Article
Your doctor may do other tests to check for high blood pressure, heart disease, diabetes, high cholesterol, and other causes of, and risk factors for TIAs or stroke.
Treatment
If you have had a TIA within the last 48 hours, you will likely be admitted to the hospital so that doctors can search for the cause and observe you.
High blood pressure, heart disease, diabetes, high cholesterol, and blood disorders will be treated as needed. You will be encouraged to make lifestyle changes to reduce your risk of further symptoms. Changes include quitting smoking, exercising more, and eating healthier foods.
You may receive blood thinners, such as aspirin or Coumadin, to reduce blood clotting. Some people who have blocked neck arteries may need surgery (carotid endarterectomy). If you have an irregular heartbeat (atrial fibrillation), you will be treated to avoid future complications.
Aspirin
Current guidelines recommend that people with coronary artery disease (CAD) receive antiplatelet therapy with either aspirin or clopidogrel. Aspirin ...

Carotid endarterectomy
Carotid artery surgery is a procedure to treat carotid artery disease. The carotid artery brings needed blood to your brain and face. You have one o...

Outlook (Prognosis)
TIAs do not cause lasting damage to the brain.
But, TIAs are a warning sign that you may have a true stroke in the coming days or months. Some people who have a TIA will have a stroke within 3 months. Half of these strokes happen during the 48 hours after a TIA. The stroke may occur that same day or at a later time. Some people have only a single TIA, and others have more than one TIA.
You can reduce your chances of a future stroke by following up with your provider to manage your risk factors.
When to Contact a Medical Professional
A TIA is a medical emergency. Call 911 or the local emergency number right away. DO NOT ignore symptoms just because they go away. They may be a warning of a future stroke.
Prevention
Follow your provider's instructions on how to prevent TIAs and strokes. You will likely be told to make lifestyle changes and take medicines to treat high blood pressure or high cholesterol.
Reviewed By
Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Internal review and update on 08/20/2021 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Biller J, Ruland S, Schneck MJ. Ischemic cerebrovascular disease. In Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. Philadelphia, PA: Elsevier; 2022:chap 65.
Crocco TJ, Meurer WJ. Stroke. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 91.
January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS focused updated of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(1):104-132. PMID: 30703431 pubmed.ncbi.nlm.nih.gov/30703431/.
Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(7):2160-2236. PMID: 24788967 pubmed.ncbi.nlm.nih.gov/24788967/.
Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021;52(7):e364-e467. PMID: 34024117 pubmed.ncbi.nlm.nih.gov/34024117/.
Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.
Riegel B, Moser DK, Buck HG, et al; American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017;6(9). pii: e006997. PMID: 28860232 pubmed.ncbi.nlm.nih.gov/28860232/.
Wein T, Lindsay MP, Côté R, et al. Canadian stroke best practice recommendations: Secondary prevention of stroke, sixth edition practice guidelines, update 2017. Int J Stroke. 2018;13(4):420-443. PMID: 29171361 pubmed.ncbi.nlm.nih.gov/29171361/.
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.
Wilson PWF, Polonsky TS, Miedema MD, Khera A, Kosinski AS, Kuvin JT. Systematic review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2019 Jun 25;73(24):3242]. J Am Coll Cardiol. 2019;73(24):3210-3227. PMID: 30423394 pubmed.ncbi.nlm.nih.gov/30423394/.