Transient ischemic attacks (TIAs), also called mini-strokes, are medical emergencies that should prompt an immediate call to 911. It’s estimated that about 240,000 TIAs occur in the United States each year, according to the American Heart Association (AHA).
TIAs last a few minutes to a few hours and don’t cause damage to brain tissue. But this key warning sign puts those affected at risk for a stroke in the future. One out of three people who have a mini-stroke go on to have a more serious stroke within a year, according to the AHA.
The basics of mini-stroke
A mini-stroke occurs when blood flow to part of the brain stops for a short time. This can happen when an artery that carries blood to your brain is blocked by a blood clot (a small solid clump). Or, it can happen when an artery in the neck or brain narrows, making it hard for blood to pass through.
Symptoms of a mini-stroke happen suddenly and usually go away in about 30 minutes, although they could last up to 24 hours. During that time, there is no way to know if a person is having a mini-stroke or a full stroke. That is why emergency medical care is so important.
These warning signs can include:
- Loss of feeling or weakness in your face, arm, or leg on one side of your body
- Loss of vision in one or both eyes, or double vision
- Having trouble walking
- Feeling dizzy or confused
- Having trouble understanding someone who is speaking
- Having trouble speaking or slurring your words
- Being clumsy or off-balance
If you have any of these warning signs, get help right away. Call 911 for an ambulance.
Risk factors for mini-stroke
There are two types of risk factors for mini-strokes: ones you can control and ones you can’t.
Risk factors you can’t control or change include having a family history of a stroke or mini-stroke and being older than 55. Men have a slightly higher risk than women.
You can take charge of some risk factors to lower your risk for stroke, even if you’ve already had one. These actions can include:
- Managing high blood pressure
- Quitting smoking
- Lowering high cholesterol
- Managing type 2 diabetes
- Maintaining a healthy weight
- Following a healthy diet that’s low in fat and salt
- Getting plenty of physical activity
- Limiting alcohol
If you drink, do so in moderation. Women should limit themselves to one drink per day, while men should limit themselves to two.
You can work with your healthcare providers to follow a healthy lifestyle, lower your risk for heart or blood vessel disease, and manage your blood pressure, cholesterol, and blood sugar. Taking these steps can go a long way in reducing your risk for a stroke or mini-stroke.
Diagnosis and treatment of a mini-stroke
When you get to the emergency department, doctors can diagnose a mini-stroke based on your symptoms and a physical exam. In many cases, the symptoms will be going away or already gone. Mini-strokes don’t usually cause permanent brain damage, but it is still important to find out if there are possible problems that can lead to another mini-stroke or a full stroke. In many cases, a doctor will order a brain and neck imaging study to look for any blood vessel narrowing that could lead to a future stroke. It will also be important to identify any risk factors that need to be treated, like high blood pressure or high cholesterol. Blood tests can help shed light on these and other risk factors.
The goals of mini-stroke treatment are to reduce the risk for another mini-stroke or a full stroke in the future. Treatment may include medications to reduce the risk for blood clots and to treat conditions like high cholesterol or high blood pressure. In some cases, if an imaging study shows a narrowed blood vessel in the neck, a surgical procedure to keep the blood vessel open (called angioplasty) may be needed.
The most important thing to know
It’s critical to understand that a mini-stroke is an emergency that should never be ignored. A person who has a mini-stroke is 10 times more likely to have one in the future compared to someone the same age and sex who has never had one, according to the AHA.
If you experience the warning signs of a mini-stroke, get to the nearest emergency department right away so you can start a stroke prevention program to help reduce your future stroke risk.
Sources: American Heart Association. A new defini... + 5
- American Heart Association. A new definition for transient ischemic attack and stroke. May 7, 2009.
- American Heart Association. Let’s talk about transient ischemic attack (TIA). 2020.
- National Institute of Neurological Disorders and Stroke. Transient ischemic attack (TIA). December 19, 2024.
- American Heart Association. Limiting alcohol to manage high blood pressure. May 7, 2024.
- American College of Physicians. Take TIAs as seriously as a stroke. May 2023.
- Amin HP, Madsen TE, et al. Diagnosis, workup, risk reduction of transient ischemic attack in the emergency department setting: A scientific statement from the American Heart Association. Stroke. 2023 Mar;54(3):e109-e121.
