TIA: Symptoms and Treatment

Transient ischemic attack is a short-term reduction in cerebral blood flow, the symptoms of which should disappear within a day.

The relevance of the problem of TIA can not be overestimated, since it is this very first anxious bell of a possible stroke. Stroke after TIA can develop within 3 months, the risk of this is 17%, and in 60% of cases the same arterial pool is affected. Even if the stroke does not develop within 3 months, then the possibility of its development increases by 5 times.

Who is subject to TIA?The main "culprit" is all the same ill-fated atherosclerosis, since it is in 90% of cases leads to a narrowing of the lumen of the cerebral vessels, and with the rupture of the atherosclerotic plaque, thromboembolism. Clinically, it manifests itself in the form of arterial hypertension, diabetes mellitus, obesity, hypercholesterolemia, smoking, IHD, arrhythmias with cardiogenic embolisms. Apart from such diseases as vasculitis and blood pathology, they are much less common. Eventually, all this leads to a local disturbance of the cerebral blood flow and the appearance of the corresponding symptomatology.

Classification of TIA

Depending on the severity of the clinical course, the following options are distinguished:

• easy flow (symptoms last no more than 10 minutes and regress). Most often in such a course, patients do not seek medical help and do not attach any significance to this episode of ischemia. The drama of the situation is that this episode is not the last and after some time will manifest itself as a clinic for a detailed stroke;
• moderate severity (symptoms are observed for several hours);
• severe (symptoms persist throughout the day). Such a TIA must be differentiated with a stroke.

Depending on the frequency of occurrence, the following TIAs are distinguished:

• single (no more than 2 times a year);
• average frequency (3-6 times a year);
• Frequent (more than once a month).

Symptoms of TIA

One of the signs of TIA is marked dizziness with nausea.

As with stroke, the symptomatology of TIA depends on the localization of the ischemic process, i.e., from the one in which the arterial basin arose ischemia. Summarize the following symptoms:

• speech disorder or speech is muffled;
• nausea, especially if accompanied by vomiting;
• intense dizziness;
• numbness of the face;
• short-term vision impairment;
• temporary motor and sensory disorders;
• disorientation in place, space and self.

Ischemia in the carotid basinmanifested hemispheric symptoms. The patient will make the following complaints:

• sudden sharp drop in vision or blindness to one eye for several minutes;
• optico-pyramidal syndrome (decreased vision or blindness is combined with weakness in opposite extremities);
• brachiofacial paresis (flattening of the nasolabial fold and numbness of the hand on the opposite side);
• cortical dysphasia (speech disturbance).

Ischemia in the vertebrobilar arterial basinoccurs with cerebellar-stem symptomatology. The patient will have the following complaints:

• marked dizziness, which is accompanied by nausea and vomiting, a shaky walk. The patient looks like a drunk;
• the patient sees indistinctly, the image is doubled in the eyes;
• fuzzy speech, possible difficulty swallowing;
• photopsy in both eyes;
• nystagmus (eyelid tremor).

There are some conditions that give similar symptoms to TIA. These include:

• comatose conditions in diabetes mellitus;
• epileptic seizures;
• a migraine attack with an aura;
• transient global amnesia;
• debut of multiple sclerosis;
• Ménière's disease.

Diagnostic TIA

TIA is an insidious disease, and the insidiousness of the disease lies in the fact that at the time of arrival an ambulance team at the patient undergoes all the symptoms and the patient does not particularly want hospitalized. Nevertheless, hospitalization is always insisted, and it is really necessary, since it is necessary to find out the cause of this condition: it can happen again. In addition to the mandatory minimum (clinical and biochemical analyzes of blood, urine, ECG, examination of the neurologist, cardiologist, oculist, if necessary - related specialists, etc.). it is necessary to conduct an additional examination: computed tomography, electroencephalography, magnetic resonance imaging, ultrasound examination of vessels, angiography.

Treatment of TIA

In the classical version, the TIA lasts an average of 12 minutes, according to the current definition, the symptoms should regress within an hour. If the symptoms do not disappear within a day, then this condition is treated as a stroke. The severe course of TIA should be treated in a neurological hospital as a stroke, and a CT scan is also required. The main task of treating such a patient is to treat the underlying disease and prevent subsequent TIA. Treatment is aimed at correcting all risk factors and lifestyle changes: reducing excess body weight, compliance with the hypocholesterin diet, moderate daily physical activity, smoking cessation and abuse alcohol. Unfortunately, most people do not pay much attention to lifestyle changes, although cessation of smoking reduces the risk complications by 60%, and the transition to the Mediterranean diet - by 50%, while taking drugs reduces the risk of only 30%.Drug methods include the mandatory use of aspirin and clopidogrel, statins, oral anticoagulants, hypotensive drugs. According to the indications, surgical intervention aimed at revascularization is performed.

In conclusion, I would like to note that even a one-time episode of TIA is not the last and serves as a serious reason to think about your health and change something in your way of life.