Both transient ischemic attacks (TIAs) and strokes occur when a blockage limits blood supply to the brain. People sometimes refer to TIAs as ministrokes.

The World Stroke Association estimates that 12.2 million people will experience a stroke for the first time this year. In the United States alone, more than 795,000 strokes occur each year, and almost a quarter of those occur in people who have had a previous stroke.

This article discusses the causes, symptoms, and treatment of TIAs and stroke. It also discusses ways to prevent these events.

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There are several types of stroke, each with its own causes.

TIAs

A TIA is the result of a temporary blockage in a blood vessel supplying the brain. It causes symptoms that may last anywhere from a few minutes to 24 hours.

However, a TIA can be a warning sign that someone may experience a more severe stroke in the future. According to the American Stroke Association, about 1 in 5 people may have a stroke within 90 days of experiencing a TIA.

Ischemic stroke

Ischemic strokes are the most common type, making up about 87% of all strokes. Similar to TIAs, they occur when a blood clot or other particles obstruct a blood vessel supplying the brain. Atherosclerosis is the primary cause of these obstructions.

Hemorrhagic stroke

Hemorrhagic strokes occur when a weakened blood vessel in the brain ruptures or leaks, causing blood to build up and put pressure on the surrounding brain tissue. There are two main ways in which a hemorrhagic stroke can happen:

Recognizing stroke symptoms quickly and seeking immediate medical help can reduce the brain damage a stroke may cause.

Symptoms can come on quickly and without warning. Despite having different causes, all types of stroke have similar symptoms since they all affect blood flow to the brain.

The American Stroke Association recommends using the FAST method to spot the most common warning signs:

  • F: face drooping to one side or numbness in the face
  • A: arm weakness or numbness, especially in one arm
  • S: speech difficulty or slurred speech
  • T: time to call 911 for medical attention

Other symptoms of stroke can include:

All types of stroke, including TIAs, are medical emergencies. If a person thinks someone is experiencing a stroke, they should call 911 or visit the nearest emergency room.

Healthcare professionals treat TIAs and ischemic strokes differently than hemorrhagic strokes.

TIAs and ischemic stroke

The treatment for TIAs and ischemic strokes is similar since both result from blockages in the blood vessels. Treatments can include a combination of medical procedures and medications, such as:

  • Tissue plasminogen activator (tPA): Doctors mainly use tPA to treat ischemic strokes. The medication breaks up the clot in the blood vessel so that blood can begin to flow to the brain as usual. A medical professional usually administers tPA within 3 hours after symptoms start.
  • Anticoagulants: A medical professional may administer an anticoagulant if tPA is not an option. These medications help prevent blood clots from forming or stop them from becoming larger.
  • Antiplatelet medication: Doctors may administer this type of medication. It prevents platelets — a component of blood — from sticking together and reduces the formation of blood clots.
  • Mechanical thrombectomy: During this procedure, a healthcare professional threads a long, flexible tube through the upper thigh up to the blocked vessel in the brain. Then, they use a stent retriever to remove the blood clot from the blood vessel.

Hemorrhagic strokes

Treatment for hemorrhagic strokes can differ depending on how severe the bleed is and what part of the brain it affects. The main goal of treatment is to promote blood clotting and reduce pressure on the brain.

Hemorrhagic stroke treatments include:

  • Blood pressure reduction: Doctors may administer beta-blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, or hydralazine to lower blood pressure.
  • Aneurysm clipping: In this surgical procedure, a doctor places a clamp at the base of the aneurysm to cut off the blood supply and prevent it from bleeding.
  • Coil embolization: In this procedure, a medical professional places a catheter into an artery from the groin, and a tiny coil pushes through into the aneurysm. The coil will cause a blood clot to form, preventing blood flow from the aneurysm into surrounding brain tissue.
  • Surgery: A doctor can perform several surgical procedures to improve overall outcomes after a stroke. These include:
    • temporarily removing part of the skull to reduce the pressure from swelling
    • removing pooled blood
    • removing or shrinking an AVM — radiation may also help achieve this

People may have some risk factors for stroke that they cannot modify. Populations with an increased risk of stroke include:

  • People over 65: A person’s risk of stroke increases as they get older.
  • People with a family history: A person may have a higher risk of stroke if they have a relative who has experienced one.
  • African American people: African Americans have a higher likelihood of dying from stroke than white people do, possibly because they have a greater risk of health conditions such as high blood pressure and diabetes. Inequities in healthcare may be one reason for this.

However, people may be able to reduce their risk of stroke through lifestyle strategies such as:

TIAs and stroke have similar symptoms. Recognizing these symptoms quickly and seeking medical help can improve a person’s outlook after the event. People should seek immediate medical attention if they think someone is experiencing a stroke or TIA.

While many studies have highlighted risk factors that people cannot modify, people may be able to reduce their risk of a stroke and TIA by making lifestyle changes. People should speak with a healthcare professional about their risk of stroke and how they may be able to reduce it.