Transient ischemic attack: symptoms and treatment

Transient ischemic attack (TIA) — insufficiency of cerebral circulation due to vascular disorders, heart diseases and lowering of arterial pressure. More common in people with osteochondrosis of the cervical spine, cardiac and vascular pathology. The peculiarity of a transiently arisen ischemic attack is the complete restoration of all the fallen out functions within 24 hours.



The significance of TIA is that it is a harbinger of myocardial infarction and cerebral stroke. The condition requires rapid diagnosis and treatment to reduce the risk of these serious complications.

The following factors contribute to the onset of a transient cerebral ischemic attack:


  • destructive changes in the spine;
  • expansion of the heart chambers
  • increased blood clotting
  • high activity of vasoconstrictors (prostaglandins, prostacyclin, thromboxane)
  • Changing the vascular wall of large arteries of the brain (carotid, vertebral, main).

There are cases when a transient ischemic attack affects children. The main role in the mechanism of pediatric pathology is given to microembolism from the heart and microthrombosis on the background of hypercoagulability.

Symptoms of TIA

In most cases, transient ischemic attacks have symptoms that warn of an upcoming catastrophe. These are:


  1. Common headaches;
  2. sudden dizziness attacks
  3. visual impairment (darkening, «goose bumps» before the eyes)
  4. Numbness of body parts.

The pattern of a transient ischemic attack is manifested by an intensifying headache of a certain localization. Dizziness is accompanied by nausea and vomiting, there may be disorientation or confusion. The severity of the condition is determined by the duration of cerebral ischemia and the level of arterial pressure. The clinical picture depends on the location and degree of vascular pathology.

TIA in the carotid artery system

Typical symptoms develop within 2-5 minutes. Circulatory disturbances in the carotid artery have characteristic neurological manifestations:


  • weakness, difficulty in limb movement on one side
  • loss or decrease in the sensitivity of the right or left half of the body
  • speech disturbance from complete absence to insignificant difficulties
  • sudden full or partial loss of vision.

Features of the carotid artery

As a rule, the transient appearance of ischemic attack in the carotid artery system has objective symptoms:


  1. impaired heart rate
  2. noise while listening to the carotid artery
  3. pathology of the retina vessels

The focal symptoms of brain damage in the pathology of the carotid artery are characteristic. Transient ischemic attack is manifested with specific neurological signs, namely:


  • face asymmetry
  • Sensitivity impairment
  • pathological reflexes;
  • Pressure fluctuations
  • narrowing of the fundus of the fundus.

The pathology of the carotid artery is also manifested not by cerebral symptoms: heaviness in the chest, interruptions in the work of the heart, lack of air, tearfulness, cramps.

TIA of the vertebro-basilar system

The clinical picture of a transiently developed ischemic attack demonstrates both cerebral and specific signs. They depend on the location and degree of involvement of the main and vertebral arteries, as well as their branching. The patient’s condition is determined by the development of collateral circulation, the degree of hypertension and the presence of concomitant diseases.

The transient ischemic attack in the vertebrobasilar basin is 70% of all cases of TIA. This frequency is due to a slow flow of blood through the vessels of this brain area.

Motor disorders can be not only one-sided, but also different localization. There are cases of paralysis of all limbs. The degree of defeat is different: from weakness to paralysis.





  1. Sensitivity disorders are often one-sided, but may also change their localization.
  2. Total or partial loss of vision.
  3. Dizziness is accompanied by a double vision, a violation of swallowing and speech. Vomiting often occurs.
  4. Attacks of short-term falling without losing consciousness
  5. Feeling of the circular rotation of objects, unsteadiness of gait. Dizziness is worse when the head turns.

Isolated symptoms are not signs of TIA. The diagnosis of a transient ischemic attack can be made only with their combination. If there are symptoms listed in points 1 and 2, then the patient has a transient ischemic attack with all the consequences.

Diagnostics

All patients who develop a transiently developing ischemic attack are immediately delivered to the clinic. Early diagnosis and timely treatment will allow to «block» the way to a stroke. Patients are delivered to the neurological department, equipped with the necessary diagnostic complex.

Scheme of clinical examination

The list of mandatory diagnostic methods for a transiently ongoing ischemic attack includes:


  • Auscultation of carotid arteries
  • blood pressure measurement
  • a blood test with an expanded leukocyte formula
  • Lipid blood spectrum: cholesterol and triglyceride levels
  • state of the coagulation system
  • ECG
  • ultrasound of the vessels of the head and neck
  • electroencephalography
  • MRI with angiography
  • Computerized tomogram

All patients should undergo examinations, because in the future the consequences can be irreversible and lead to disability or fatal outcome. A clinic transiently passing ischemic attack can mask a number of serious diseases.

Differential Diagnostics

Some of the symptoms that characterize the transient course of ischemic cerebral attack are similar to manifestations of other neurological diseases, namely:


  1. A migraine attack is accompanied by visual, speech disorders
  2. After an epileptic fit, there comes a period of muffled consciousness with a decrease in sensitivity;
  3. Diabetes mellitus manifests itself in various neurological symptoms: paresthesia, dizziness, loss of consciousness
  4. Multiple sclerosis can debut with symptoms of TIA
  5. In Meniere’s disease, seizures are accompanied by vomiting, dizziness.

After an objective clinical examination, differential diagnosis can proceed to justified treatment.

Treatment

Medical assistance is aimed at arresting an ischemic episode and preventing stroke of the brain. Specific treatment of transient ischemic attack consists in restoration: cerebral blood flow, optimal blood pressure, heart function, anti-coagulation system. To achieve the goal, the following drugs are used:


  • antihypertensive therapy: beta-blockers, clonidine, labetalol;
  • Cavinton, vinpocetine, ceraxon are used to restore the blood circulation of the brain
  • rheological properties are restored with trental, rheosorbylact;
  • statins for the normalization of cholesterol;
  • drugs tonic vessels of the brain — troxevasin, venoruton.

In addition to taking medications, the patient should be aware that a transient current episode of ischemic attack does not occur if all prevention measures are followed.

TIA Warning and Forecast

Preventive measures prevent cerebral and cardiac complications: cerebral stroke and myocardial infarction. They consist in a constant monitoring of lipid spectrum of blood and arterial pressure. In addition to medicines, the patient must follow the recommendations on dietary nutrition, motor and drinking regimen.




Regular exercise, the rejection of animal fats and bad habits, the use of a sufficient amount of liquid (at least 1.5 liters per day) will provide a favorable forecast. Remember that these simple recommendations can not only prolong, but also save a person’s life.