Transient Ischemic Attack
Alternate Names : TIA, Reversible Ischemic Neurologic Disease (RIND), Ministroke
What can be done to prevent the condition?
Transient ischemic attacks can be minimized by addressing known risk factors
for stroke. The American Heart Association guidelines for stroke prevention
address both modifiable and less well-documented or potentially modifiable risk
factors.
Measures to reduce the modifiable risk of
high blood pressure include:
measurement of blood
pressure in
adults at least every 2 years to screen for
high blood pressure
weight control
physical activity
moderation in alcohol
intake
moderate sodium intake
for those who smoke, quitting
smoking
medications to treat high blood pressure if the person's blood pressure is
over 140/90 after 3 months of these lifestyle modifications, or if the initial
blood pressure is over 180/100
Other measures to reduce an individual's modifiable risk factors for stroke may
include:
smoking cessation
using nicotine
patches, counseling, and formal smoking programs
control of blood sugar levels in a person with diabetes through medication, diet, and exercise
the use of ramipril in people with diabetes. A recent study showed that people with diabetes have a 33% lower risk of stroke if they take ramipril.
careful evaluation of asymptomatic carotid stenosis to determine the need for surgery. Coronary artery surgery, such as an endarterectomy,
may be
indicated. An endarterectomy opens the narrow portion of the artery and
increases the blood flow to the brain. People with carotid stenosis should
also work closely with their healthcare providers to control other risk factors
for stroke.
semiannual screening of children with
sickle cell anemia, using ultrasound to determine the child's risk
of
stroke
treatment of atrial
fibrillation
with blood thinners such as aspirin or warfarin, depending on the person's age
and other risk factors
monitoring of high levels of total cholesterol or LDL, as well as low
levels of HDL. Depending on the blood levels and the person's other risk
factors, medications to lower cholesterol may be given.
Measures to reduce less well-documented or potentially modifiable risks for
stroke may include:
weight reduction in overweight persons
30 or more minutes of moderate exercise a day for most individuals.
People with heart disease
or
disabilities should be in a medically supervised exercise program.
a healthy diet for preventing heart
disease,
containing at least 5 fruits and vegetables a day
for those who drink
alcohol,
drinking in moderation. The AHA defines moderate drinking as no more than 2
drinks a day for men and 1 drink a day for women.
seeking treatment for drug
abuse
monitoring of blood levels of homocysteine. For most individuals, a
well-balanced diet following the food guide pyramid will provide enough folic
acid and B vitamins to maintain a healthy homocysteine level. For people with
elevated homocysteine levels, supplements containing folic acid and B vitamins
may be recommended.
avoiding the use of oral contraceptives in women with other stroke risk
factors
What are the long-term effects of the condition?
There are usually no long-term effects of the transient ischemic attack itself.
However, a recent study showed that people who had a TIA increased their
chance of having a stroke by 50% in the 3 months following the TIA. Twenty
percent of these strokes were fatal, and two-thirds were disabling.
Furthermore, the increased risk of stroke in the 3 months after a TIA was
linked to 5 factors:
age over 60 years
diabetes
a TIA lasting more than 10 minutes
weakness with the
TIA
speech impairment
with the TIA
What are the risks to others?
TIAs are not contagious and pose no risks to others.
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