Transient ischemic attack (TIA) is manifested by an acute violation of cerebral circulation, all the consequences of which are restored within a day after their formation. Such manifestations are temporary and pass on their own, so they are called transient. Many patients with such attacks do not go to the doctor. Although statistics show that more than half of patients with stroke have suffered a TIA before. Transient ischemic attack according to ICD-10 has the general code G45. More detailed encryption indicates the location of violations. For example, a temporary memory loss code is designated G45.4. Most often, this disease affects the elderly.
What is a transient ischemic attack?
This is a temporary circulatory disorder in the brain. Otherwise, it is called a microstroke. TIA is a critical condition that portends an impending stroke. However, after no more than 24 hours, it passes without the development of a heart attack. A transient ischemic attack is formed when one of the vessels supplying the brain is blocked. The blood flow through the vessel is blockedformed atherosclerotic plaque or thrombus.
Due to lack of blood in some parts of the brain, oxygen starvation begins, and their functioning is disrupted. In some cases, the disease occurs due to hemorrhage, but in this case, blood circulation is quickly restored. The disease is insidious in that it is not taken seriously, its manifestation is considered overwork or a consequence of stress. Sometimes symptoms occur during sleep, and the patient simply does not suspect that he has had a transient ischemic attack, since there are no consequences left. Therefore, neurologists advise to undergo an examination once a year for the purpose of prevention.
Classification of TIA
The following degrees are distinguished according to the severity of the course of the disease:
- Mild - symptoms appear for about ten minutes, and then everything is restored. With such a course, patients do not attach importance to the disease and do not go to the doctor, but after a while the attacks recur.
- Medium - signs can be observed up to several hours, but no consequences occur.
- Severe - symptoms persist for days.
According to the location of the thrombus, in connection with the international classification, transient ischemic attack has one of the following options for the course of the disease:
- carotid syndrome;
- global transient amnesia;
- unspecified forms;
- multiple bilateral symptoms of cerebral arteries;
- arterial vertebrobasilar syndromesystem;
- transient blindness.
Causes of disease
For the development of the disease, there are many different prerequisites that have a negative impact on the state of cerebral vessels and blood clotting. The following conditions are considered to be the main factors contributing to the development of transient ischemic attack:
- Osteochondrosis of the cervical spine.
- High blood pressure.
- Thromboembolism resulting from heart disease: arrhythmias, myocardial infarction, valvular malformations, endocarditis, congestive heart failure.
- Progressive atherosclerotic vascular changes. As a result, cholesterol plaques are formed, which are carried with blood through the vessels and can block them, slowing down the blood flow.
- Diabetes mellitus.
- Failures in metabolic processes.
- Atrial fibrillation.
- Anomalous tortuosity of cerebral vessels.
- Autoimmune and inflammatory diseases of the blood vessels.
- Antiphospholipid syndrome.
- Angiopathy, which is manifested by dystonia, temporary reversible spasms and vascular paresis.
- Bleeding and coagulopathy (blood clotting disorder). These phenomena also lead to the formation of blood clots and blockage of blood vessels.
- Migraine.
The risk factors and causes of transient ischemic attack include the following phenomena:
- artificial heart valves;
- alcoholism: poisoning the body or its systematic use even in small doses;
- tobacco abuse;
- small physical activity.
The more triggers a person has, the higher the risk of a TIA. Children with severe heart disease and endocrine disorders show symptoms of transient ischemic attack.
TIA disease in children
Basically, the disease is diagnosed in people of the older age category, this is due to the natural aging of the body. What causes TIA in children and adolescents? Among the important factors in the development of the disease are:
- atherosclerosis of the arteries of the neck and head;
- various deviations of the vascular bed;
- Clot formation in heart chambers and valves associated with bleeding disorders, uncoordinated contraction of the heart muscle and infections.
To find out the exact cause of transient ischemic attack in children, a complete examination is necessary. First of all, parents should show their child to a neurologist who:
- will conduct a conversation and find out all the details of the onset of the disease, exercise tolerance, find out a family history;
- to determine the patency of cerebral vessels will prescribe a study using CT or MRI;
- EEG (electroencephalogram) will help rule out epilepsy.
The next doctor is a pediatrician. Most likely, a comprehensive analysis of blood coagulation parameters will be required, usingwhich it is possible to exclude or confirm congenital diseases associated with it. The process of blood clots also develops as a result of the use of contraceptives by a teenager, frequent visits to the solarium, the use of dietary supplements, drugs or alcohol. The next important reason is a tumor, as a result of which thrombosis can occur. CT and MRI data are used to identify it.
It is necessary to conduct a blood test for the amino acid homocysteine. In people who are deficient in vitamin B6 and B12, its level rises, and this contributes to the development of atherosclerosis and provokes blood clots.
The child's hereditary predisposition to high blood cholesterol also contributes to early atherosclerosis. To confirm this, a blood test for lipoprotein A is needed.
It remains to visit a cardiologist who will listen to heart murmurs and tones. To clarify pathologies, an electrocardiogram, ultrasound of the heart and neck vessels is necessary. The doctor will look for birth defects that can cause abnormal blood flow and blood clots.
Examinations will take a long time to pass, but they are necessary to identify the causes in order to undergo timely treatment of transient ischemic attack and prevent further development of the disease.
Blood supply to the brain
Symptoms of the disease depend on the area of the brain where the damaged vessels are located. There are two vascular pools:
- Carotid, where the carotid arteries are located. They affect the blood supply to the hemispheresbrain responsible for sensitivity, motor activity and higher nervous activity.
- Vertebrobasilar, contains the vertebral and basilar arteries supplying the brainstem. This part of the brain is responsible for vital functions: vision, blood circulation, memory, breathing.
Symptoms of transient ischemic attack in case of circulatory disorders in the carotid pool
Manifestations of disease:
- Impaired motor ability in the limbs. Often this occurs on one side: the left arm and leg, or only in one limb. In some cases, paralysis throughout the body is possible.
- No sensation in half of the body (left or right), or both at the same time.
- Paralysis of half of the face. When smiling, there is an asymmetrical lifting of the upper lip.
- Speech gets frustrated: vagueness of spoken words appears, there is no ability to understand what is heard, and one's own speech can be incoherent and incomprehensible in meaning, there is an inability to pronounce words correctly or there is a complete absence of speech.
- Impaired vision: both or one eyeball stop moving, partial or complete blindness occurs.
- Intellectual abilities disappear: the patient cannot tell where he is, determine the time.
- Failure in higher nervous activity is manifested by the inability to write and read.
Symptoms caused by impaired circulation in the vertebrobasilar basin
In this case, signs of a transient ischemic attack appear:
- unsteadiness of gait - swaying from side to side;
- constant dizziness - everything seems to be spinning;
- headaches in the back of the head;
- sweeping and inaccurate movements;
- shivering limbs;
- limited eyeball movements in one or both eyes;
- tinnitus;
- loss of sensation in one half of the body or throughout the body;
- delayed and irregular breathing;
- impaired ability to move limbs;
- unexpected loss of consciousness.
Diagnosis of disease
If the TIA progresses quickly, the symptoms of the disease will most likely disappear before the arrival of an ambulance or a visit to the doctor, so the following tests are required when diagnosing a transient ischemic attack:
- Analyze the patient's complaints and collect an anamnesis of the disease: find out how much time has passed since the first symptoms, whether vision, gait, sensitivity were disturbed, whether diseases of the heart and blood vessels were diagnosed before.
- Conduct a visual examination of the patient for loss of vision, sensitivity, movement of the limbs.
- Blood test for clotting.
- Urine test to check liver and kidney function.
- CT - to determine vascular obstruction.
- ECG - detects signs of heart rhythm failure.
- Ultrasound of the heart - performed to detect blood clots.
- Ultrasound of vessels at the levelneck and nourishing the brain.
- TKDG - the blood flow of the arteries located in the skull is assessed.
- MRI - the patency of the arteries inside the skull is visible.
- If necessary, consult a therapist.
Based on the collected history, the results of the analysis and the data obtained during the examination, the patient is given an accurate diagnosis, and the doctor prescribes the appropriate course of treatment.
TIA treatment
Clinical guidelines for transient ischemic attack are aimed at therapy, which should focus on eliminating the causes of the disease and preventing relapse. For a speedy recovery, treatment begins immediately after the patient seeks medical help. He is admitted to the neurology department. The following groups of drugs are used for therapy:
- Reducing blood pressure. They begin to be used on the second day after the disease, otherwise there will be a decrease in the blood supply to the brain.
- Anticoagulants - reduce the activity of blood clotting, do not allow blood clots to form.
- Statins are used to treat transient ischemic attack. They help prevent atherosclerosis and reduce the amount of cholesterol in the blood.
- Neuroprotectors - improve brain nutrition.
- Antiarrhythmic - restore heart rhythm.
- Coronarytics - relieve spasm of blood vessels.
- Improve cerebral circulation.
- Nootropics - to support the work of neurons.
Complications and consequences
With a quick response to symptoms and timely treatment, a person returns to normal life after a short period of time. The consequence of a transient ischemic attack, not treated in a timely manner, is an ischemic stroke, which develops in half of all people who have had the disease. The result is persistent neurological defects:
- paralysis - impaired movement of the limbs;
- memory loss, cognitive loss;
- depression, distraction, irritability;
- slurred speech.
In some cases, the prognosis is disappointing, leading to disability, and sometimes death.
Prevent TIA
To prevent the occurrence of the disease, you must:
- Increase physical activity. Moderate physical activity normalizes blood circulation, strengthens the immune system and stabilizes the respiratory system, reduces the risk of TIA. Preference is given to walking, swimming, therapeutic exercises, cycling and yoga.
- Follow your diet. In the diet, fatty, s alty, smoked, spicy, canned foods should be limited. Give preference to cereals, vegetables and fruits. For high blood clotting and high blood sugar, seek help from a nutritionist for a special nutrition program.
- Timely treatment of chronic diseases. With the exacerbation of any disease, timely support is required.body with medicines prescribed by a doctor.
- Control blood pressure. If necessary, correct with medication.
- Give up bad habits: smoking and alcohol.
- Removing risk factors. Systematically monitor cholesterol levels and blood clotting. If necessary, urgently correct them.
The abnormal condition caused by TIA should not be ignored, it will worsen over time. This disease warns a person of an increased risk of stroke. Having listened to such a signal, the patient should prevent the subsequent deterioration of he alth and return to normal life.
