What is transient ischemic attack (TIA)?

A transient ischemic attack (TIA) is a brief loss in brain function. It happens when the brain does not get enough blood because a blood vessel is blocked for a short time. The blockage may be caused by a sudden narrowing of the blood vessels in the brain, a clot that travels from another part of the body to the brain or neck, or a spasm of an artery leading to the brain.

Symptoms of TIA and stroke are the same, except TIA symptoms usually go away in a few minutes, and always within 24 hours. A TIA is different from a stroke because it does not cause any lasting damage to the brain.

If you have had a TIA, you have a high risk of having a stroke.

What can I expect in the hospital?

It is important to treat the problem that caused the TIA. Treatment for a TIA may prevent a stroke.

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your heart rate, blood pressure, and temperature will be checked regularly.
• A heart (cardiac) monitor may be used to check your heartbeat.
• Your strength, range of motion, and ability to feel pain will be checked regularly.
• Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
• Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
• Your fluid output may be monitored by keeping track of the amount of urine you produce. This may be done by placing a catheter into your bladder through the urethra (the tube from the bladder to the outside) to drain urine into a bag to measure.

Testing

Testing may include:

• Blood tests to check for blood cell levels, fats in the blood, and how well the blood clots
• Neurologic examination: Testing to check your strength, ability to feel, balance, reflexes, and memory. This will include looking at your eyes with a flashlight to see if your pupils are the same size.
• Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the brain
• Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the brain
• Carotid ultrasound scan: Sound waves and their echoes are passed through your body from a small device (called a transducer) that is held against your skin to create pictures of the inside of the arteries in the neck
• Cerebral arteriogram (also called cerebral angiogram): A series of X-rays taken after your healthcare provider places a long, thin, flexible tube (catheter) into a blood vessel in your groin or neck and injects a special dye into your blood vessels to look for areas where the dye may be leaking out of a blood vessel or blocked blood vessels
• Electrocardiogram (ECG): A test which measures and records the electrical activity of your heart

Treatment

The treatment for TIA depends on its cause, your symptoms, how well you respond to treatment, your overall health, and any complications you may have.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
• You may receive oxygen through a small tube placed under your nose or through a mask placed over your face.
• Your provider may prescribe medicines to:
  • Prevent blood clots by thinning your blood
  • Control cholesterol levels
  • Treat other conditions that may have helped cause the TIA, such as high blood pressure, heart rhythm problems or diabetes
• You may need surgery to treat TIA. Surgery may include:
  • Angioplasty: A procedure in which your healthcare provider inserts a flexible tube called a balloon catheter into a blood vessel and moves it up to the blocked blood vessel in the neck. The balloon is inflated to widen the artery and improve blood flow to the brain. A metal mesh device called a stent is usually left in the artery to help keep the blood vessel open.
  • Carotid endarterectomy: Surgery to remove a clot from a blocked artery in the neck that supplies blood to the brain, called the carotid artery.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Trouble with muscle movements, such as swallowing, moving arms and legs
  • Trouble speaking or understanding
  • Change in vision, such as double vision, blurred vision, or trouble seeing out of one or both eyes
  • Loss of bowel or bladder control
  • Severe headache
  • Seizure or convulsion
  • Loss of balance or coordination
  • Confusion
  • Personality changes
  • Dizziness or fainting
• Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on your symptoms and the treatment received. The average amount of time to stay in the hospital after a TIA is 2 to 3 days.