What is it about ?
A transient ischemic attack (TIA) is a temporary functional impairment, lasting from a few minutes to a maximum of 24 hours, and caused by a brief lack of oxygen in the brain. This is often the harbinger of a cerebral infarction.
The causes of a TIA are often the same as those of a cerebral infarction, where an artery is blocked by a blood clot. This usually results from an underlying heart rhythm disorder or calcification of the carotid arteries or arteries in the brain.
After the first TIA, almost 10% of people will have a cerebral infarction within a week and 10 to 20% within 3 months. AIT requires referral to an emergency service within 1 to 2 weeks. Prevention and early examinations reduce the risk of cerebral infarction by 80% within 3 months.
How to recognize it?
A TIA can be recognized by functional deficits. These deficits can affect motor or sensory functions. In the event of a motor deficit, the nerves that control the muscles no longer work. This leads to paralysis of one or more muscle groups. In the event of sensory deficit, the nerves responsible for sensations are affected. This leads to sensory disturbances, such as tingling, deafness, loss of feeling hot and cold, or even complete numbness in one part of the body. TIA-related functional deficits are short-lived and transient in nature. They usually start suddenly.
The following symptoms are the most common:
- Paralysis of the arm, leg and / or face, most often unilateral (affecting only half of the body);
- Difficulty speaking;
- Altered sensitivity in one half of the body;
- Blindness in one or both eyes, limitation of the visual field;
- Gait disturbance, often characterized by a shuffling, undulating gait of one leg;
- Balance disorders, accompanied by dizziness leading to a tendency to fall. The dizzy spell associated with nausea is usually not caused by TIA.
How is the diagnosis made?
The doctor will possibly suspect a TIA based on the onset and progression of symptoms. As TIA is often the first sign of a cerebrovascular accident (CVA), the doctor will systematically refer you to a hospital for additional examinations: The examinations mainly consist of a thorough examination of the heart and a neurological examination with imaging. medical.
The heart exam includes an electrocardiogram (ECG), an echocardiogram to check for structural abnormalities in the heart and the presence of blood clots, as well as a Holter ECG, which records the heart’s activity and heart rate for 24 hours. time.
The neurological examination is supplemented by a Doppler examination (a kind of ultrasound) of the carotid arteries, a CT scan and an MRI of the brain. Doppler examination of the carotid arteries checks for critical strictures and clots in the blood vessels. The CT scan takes cross-sectional recordings of the brain, which makes it possible to visualize the sliced brain. The MRI is actually a huge magnet, which creates a three-dimensional image of the brain. This examination allows the lesions to be located with great precision.
A blood test is also done to check for other underlying diseases.
What can you do ?
Prevention is better than cure. The most important thing is therefore to adopt a healthy lifestyle. Eat a healthy diet, watch your weight, don’t smoke, drink no more than 2 glasses of alcohol a day, and get enough exercise. Prevention is a top priority, especially when there is a family history.
If you suffer from other conditions such as high blood pressure, abnormal heart rhythms or diabetes, take your treatment and checks with the greatest possible care.
In the presence of signs compatible with a TIA, it is essential to react quickly to avoid a cerebrovascular accident (stroke). Contact the doctor immediately, who will refer you to a specialized center where the necessary examinations can be carried out and where appropriate treatment can be started.
What can your doctor do?
In a first phase, two possible treatments emerge: the administration of anticoagulants and an intervention on the carotid artery.
The most commonly used blood thinner is low dose salicylic acid (aspirin). This medicine makes platelets less ‘sticky’ and thus reduces their ability to form clots. True anticoagulants are only indicated for cardiac arrhythmias.
The doctor considers an intervention on the carotid artery when it is narrowed to more than 70%. The procedure involves placing a stent or bypassing.
It goes without saying that the underlying conditions such as diabetes, high blood pressure, arrhythmias, infections, … must be treated. Lowering blood pressure is the most effective way to prevent further TIA and stroke. Cholesterol lowering agents (which lower cholesterol levels) also have a proven effect.
Rehabilitation occupies an important part of the treatment, combining medical gymnastics, speech therapy, occupational therapy and home support.
Finally, psychotherapy may also be necessary to learn how to better control stressors. Indeed, the person who has had a TIA often lives in the anxiety of a future stroke.
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