TIA is a rather acute disorder of blood circulation in the brain, which can manifest itself as some signs of a stroke. However, the difference between a transistor attack and a stroke is that it lasts a short time, and also has no mental or physical consequences for a person.
In most cases, TIA episodes last no more than 3-5 minutes, but there are cases when their duration reached a day. The consequences of an ischemic attack can be severe. It is often confused with micro or ischemic stroke, as they have very similar causes. Simply put, a TIA is the first and rather revealing warning about the risk of stroke.
More on the treatment and symptoms of transient ischemic attack next.
Physiology of disease
TIA usually occurs as a result of a reduced ability of blood vessels to provide neurons with the necessaryoxygen. This disease can have very different severity, so it is often difficult for doctors to distinguish between ischemic stroke and transient attack, since these diseases develop in almost the same way.
The one most effective criterion for distinguishing a TIA from a stroke is known - the attack never lasts 24 hours, which often happens in the presence of a stroke.
TIA Causes:
- Disturbance of the rhythm of the heart system and the formation of blood clots, which can break into particles and enter the arteries with the bloodstream, thereby causing a violation of blood flow.
- Cerebral atherosclerosis: cholesterol is deposited on the walls of arteries. There is a narrowing of the vascular lumen, due to which the blood supply to the brain is disturbed, the development of atherosclerotic plaques may be noted.
- The formation of blood clots in the veins of the legs, which can also divide into particles, getting into the arteries with blood, causing impaired blood flow in the brain.
- Reducing pressure.
- Clamping of the arteries that saturate the brain with blood: this mainly occurs during surgical interventions on the carotid artery, or a strong turn of the head.
- Blood thickening.
- Risk of thrombosis, especially in developing antiphospholipid syndrome, directed against its own cells and erythrocytes.
Also, the signs that can provoke a high risk of the disease include certain features of the patient's life: obesity, alcohol and tobacco addiction, as well as a sedentary lifestylelife.
The above factors can have a negative effect on the vessels of the brain, which can narrow or lose their elasticity. If the vessels are not able to provide sufficient nutrition to the brain cells, a person may develop such a disease.
Signs of TIA
Symptoms of an ischemic attack of the brain of a transient type can be different, depending on one of the two vascular pools where the blood flow is disturbed. More details about these pools will be described below.
Carotid pool
It is formed by the carotid arteries, which are located inside. Promotes blood supply to the cerebral hemispheres, which control nervous activity, and are also responsible for the increased sensitivity of the body and its motor activity. If blood circulation is disturbed in the carotid pool, the patient may be disturbed by the following signs of an ischemic attack. And there are many of them:
- Paralysis of the face, which is noticeable when smiling or raising the eyebrows up (asymmetrical wrinkling of the forehead to the sides).
- Impaired mobility of the limbs, especially unilateral, or paralysis of the whole body.
- Dysarthria - slurring and slurring of speech.
- Motor aphasia - it is difficult for a person to pronounce words: he knows about the defectiveness of his words, so he tries to be laconic.
- Sensory aphasia - the patient does not understand the speech addressed to him: he looks disoriented, because he does not understand the speech of strangers. The patient mayspeak, but his speech is meaningless.
- Mutism - speech is completely absent.
- Mobility of the eyeballs on the sides is limited, they can be completely immobilized.
- Frozen gaze, which is directed to the right or left side.
- Partial or complete blindness.
- Cognitive impairment: a person hardly understands what time it is, what time of the year, where he came, it is difficult for him to count, write and read - the patient confuses phrases and letters in places in the text.
It is worth mentioning what it is, paresthesia of the limbs. This is one of the symptoms of this disease. Burning and tingling in the limbs that characterize TIA occurs in 60% of cases. Therefore, you need to know what it is limb paresthesia in TIA and not panic when such a symptom appears.
Vertebrobasilar basin
It is formed by two arteries located in the spine and supplies blood to the brainstem responsible for circulation, respiration and other vital functions.
In case of impaired circulation in this pool, the following symptoms of an ischemic attack usually occur:
- unsteady gait: a patient who is in a standing position will sway to the sides;
- systemic vertigo, causing the patient to try to hold on to foreign objects for balance, even when lying or sitting;
- uncoordinated movements: they are sweeping;
- impaired eye mobilityapples: mobility on the sides is limited, they may even stop moving;
- tremor: performing active movements, the patient has trembling limbs;
- disturbance of sensitivity: the border that divides the body into two parts is formed by a line drawn through the navel and the end of the nose;
- impaired mobility of certain parts of the body;
- nystagmus: eyeballs oscillate sideways;
- sudden loss of consciousness;
- impaired breathing.
Degrees of severity
The following degrees of severity of TIA are currently known, depending on the duration:
- Mild TIA - an attack lasts no more than 10 minutes. The main symptom is dizziness during an ischemic attack.
- Moderate TIA - symptoms persist for a maximum of 10 minutes, and last up to a day. Loss of consciousness during an ischemic attack is the main symptom of this stage.
- Severe TIA - an attack can last a day, organic symptoms may persist after an attack of a transient attack, or all symptoms at once. Hemiparesis in ischemic attack at this stage acts as the main symptom.
The most pronounced sign of a transient attack is the rate of spread and elimination of the disease. TIA is characterized by rapid onset, short duration, and return to normal. Episodes of TIA may recur frequently with similar symptoms.
DiagnosisTIA
To begin with, the doctor performs an anamnesis of the disease and the patient's existing complaints: finds out when complaints of sensory disturbance, impaired vision appeared, how much time has passed from the first complaints. It is important that the patient gives accurate information about whether such complaints recur during active exercise, and in a calm state, whether alarming symptoms were noted earlier.
You also need to perform a neurological examination: to look for signs of neurological problems - loss of vision and sensitivity, as well as the inability to move the limbs. You should definitely perform a blood test in order to suspect a blood clot in time.
The doctor usually prescribes the following procedures:
- MRI and CT of the head: these methods allow you to layer by layer, as completely as possible to obtain data on the structure and design of the brain. With a transistor attack, unlike a stroke, there are no special symptoms of existing pathologies in the brain.
- ECG can detect signs of heart failure.
- Ultrasound of extracranial arteries helps to examine their patency. They are usually located on the neck, and supply blood to the brain.
- Echo-KG is performed to detect blood clots in the region of the heart.
- MRI to assess the patency of the cranial arteries.
- TCDG makes it possible to assess arterial blood flow. In this case, the ultrasonic probe is applied directly to the temple area.
TIA treatment
Since, when entering a hospital, it is very difficult to assess what kind of disease a person has - ischemicstroke or transient ischemic attack - you need to urgently begin full-fledged treatment.
Usually, a patient with this diagnosis is hospitalized in neurology to be observed and treated with the participation of a psychologist, speech therapist, neurologist and cardiologist (in case of rhythm and pressure disorders). Without accurate clarification of the symptoms of TIA, it will not be possible to reduce the risk of stroke and the development of a second ischemic attack.
Typically, medicines for ischemic attack, the symptoms of which are higher, are as follows:
- Drugs that help lower blood pressure: on the first day it is absolutely impossible to lower it, as this will also reduce the blood supply to the brain.
- Thrombolytic treatment - a drug is injected into the bloodstream that will dissolve blood clots that have blocked the lumen of the cerebral arteries. But it is worth noting that this method has many contraindications, especially if at least 3 hours have passed from the onset of the first symptoms. Performing thrombolytic therapy may threaten the risk of gastric, intestinal or intracerebral bleeding due to reduced blood clotting activity.
- Drugs to improve blood flow (anticoagulants and antiplatelet agents that improve blood rheology).
- Antiarrhythmic drugs that help restore heart rhythm.
- Neuroprotectors to improve brain nutrition and speed up its recovery.
First aid for an ischemic attack is to deliver the patient to a medical facility and administer the necessary drug.
Surgery
Treatment after a transient ischemic attack may also involve the need to perform one of the following types of surgery:
- Carotid angioplasty with the possibility of stenting: a catheter is inserted into the area of the clogged artery with a balloon at its end, which is inflated and pressed against the plaque. A tube with a metal mesh inserted into the artery will prevent narrowing of the artery.
- Carotid endarectomy is used for severe or excessive narrowing of the carotid artery. During the operation, an artery is opened, after which it is thoroughly cleaned, and must be closed.
Complications
When an ischemic attack turns into a stroke, the patient develops a neurological defect:
- dysarthria, in which slurred speech is noted;
- paralysis;
- Cognitive Impairment - Cognitive impairment and memory loss.
TIA in children
Usually this disease is detected in adults, as it depends on the irreversible aging of the organs and tissues of the body. But there are cases of the disease among children, which are facilitated by the following factors:
- deviations of the vessel bed;
- atherosclerosis of the arteries located on the head;
- thrombus formation in the valves and the heart due to impaired blood clotting;
- infections;
- uncoordinated heart muscle contractions.
To find outthe cause of TIA in a child, it is necessary to initially contact a neurologist in order to perform an MRI and CT scan, as well as an EEG to rule out the occurrence of epilepsy. You also need to visit a pediatrician for a comprehensive analysis, and check the blood coagulation system. In addition, they perform an analysis for homocysteine, a special amino acid that additionally provokes thrombosis, and also provokes the appearance of atherosclerosis.
Prevent TIA
To prevent the occurrence of transient ischemic attack, the clinical recommendations are as follows. The patient needs to eat right, limiting the consumption of fried and fatty foods as much as possible. It is important to control blood pressure through the use of antihypertensive drugs.
Medical methods can also be effective to eliminate rhythm disturbances, the use of special antiarrhythmic drugs is indicated for heart rhythm disturbances, you should take drugs that eliminate blood clotting, as well as drugs to prevent thrombosis.
To improve cholesterol metabolism, reduce the activity of the atherosclerotic vascular process, the patient should take statins. Antiplatelet agents are usually taken to reduce blood clotting. Prevention of repeated transient attacks is to change the way of life, as well as the timely correction of acute diseases.
In especially severe cases, surgical narrowing of the arteries that supply the brain with a sufficient amount of blood is indicated. In case of excessive narrowing of the arteries, andwhen removing atherosclerotic plaques from the inner lining of the carotid arteries, carotid endarterectomy and extra-intracranial microanastomosis are used to narrow the cranial arteries.
Result
If a person or his relative has already suffered an ischemic attack, he needs to be extremely careful about himself, since there is a risk of further development of a stroke. The first signal of the need for help is a violation of the blood circulation of the brain. An experienced neurologist should be consulted immediately in order to identify and eliminate the possible cause causing a transient ischemic attack in time.
