woman holding hand to her head and feeling dizzy

Transient Ischemic Attacks May Be Brief But Need Serious Attention

Stroke happens when blood flow to the brain is blocked by a clot. A transient ischemic attack (TIA) is a stroke that usually lasts under five minutes, and symptoms and the cause (blood clot) resolve on their own. But just because the symptoms disappear, does not mean a TIA should be ignored. That's why there's a call out to rebrand TIAs as minor strokes, as reported in The New York Times.   

It’s important to get the label correct to increase awareness, says stroke specialist Joshua Willey, MD, associate professor of neurology at Columbia University Vagelos College of Physicians and Surgeons. “Transient symptoms are a neurological emergency.”If you have a TIA, there's a 5% to 10% chance you will have a stroke in the next 90 days, especially in the first two days. People with transient neurological symptoms that last more than five minutes frequently show permanent damage on brain imaging.  

TIAs are a warning sign that a major, life-threatening stroke may be on the way. 

A TIA is an emergency 

It is important for people experiencing a TIA to be assessed to reduce the risk of a more severe, disabling stroke. “The medical community accepts TIA as an emergency. Now it's time for patients to do so as well,” says Willey. 

Anyone experiencing stroke symptoms, regardless of how long they last, should operate under the assumption it is a stroke and go to an emergency department. However, says Willey, “Stroke is not a diagnosis to throw out cavalierly.” Other conditions can mimic the transient stroke symptoms, and a stroke diagnosis may incite anxiety or depression, or cause difficulty in getting life insurance. Physicians have to be careful to make the right diagnosis. 

About one third of people who have a TIA have a more severe stroke within one year.  

Recognize symptoms of stroke   

There's an easy way to remember and recognize stroke symptoms: BE FAST, a mnemonic that captures 90% to 95% of symptoms and signs of stroke. Sudden onset (fast!) is signal number one.   

  • B – Balance: Loss of balance or trouble walking   
  • E – Eyes: Loss of vision or double vision in one or both eyes without pain 
  • F – Face: Droopy or cannot move one side of face  
  • A – Arm: Weak; cannot lift   
  • S – Speech: Slurred, unintelligible speech  
  • T – Time to call 911: Take action. (T also stands for another symptom: terrible headache)

Remember BE FAST for yourself and others: If you or someone else has any of these symptoms, even if the symptoms go away, call 911 and go to the hospital immediately.

“No matter what you call a TIA, these symptoms are warning signs that should not be ignored,” says Willey. 


Joshua Willey is an associate professor of neurology at the Columbia University Vagelos College of Physicians and Surgeons and attending neurologist on the Stroke Service at NewYork-Presbyterian.  

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