Are you at risk for a ministroke?

May 10, 2024 | By Meredith Bailey
Hands cradle a paper cutout of human head with pink brain showing heartbeat rhythm graph

At a glance

  • A ministroke, also known as a transient ischemic attack, is a temporary blockage in the brain
  • About one-third of people who experience a TIA will have a stroke within a year
  • Anyone experiencing symptoms of a stroke or TIA should seek emergency medical care

The symptoms may last only minutes — momentary feelings of weakness on one side of the body or slurred speech, for example.

These feelings might be so fleeting that you are tempted to shrug them off, but that would be a mistake because what you may be experiencing is a transient ischemic attack (TIA).

While TIAs are sometimes referred to as ministrokes, the name is a misnomer — there is nothing mild or harmless about them.

“TIAs are really a harbinger of danger lurking in the wings,” says Madeleine Geraghty, MD, FAAN, a neurologist and medical director of the stroke program at MultiCare Deaconess Hospital. “There’s up to a 10 percent chance that a person with a TIA will go on to experience a full-fledged stroke sometime in the next three months.”

What is a TIA?

To understand what a TIA is, think of the brain as an engine powered by glucose (sugar) and oxygen. Brain cells cannot store large amounts of these fuel sources, so our blood must continuously transport glucose and oxygen to the brain through our blood vessels.

When there’s a blockage in a blood vessel, glucose and oxygen can’t get through, causing this efficient engine to break down. After using up any nearby stores of glucose and oxygen, brain cells start to malfunction. If the blockage remains for too long, the brain cells die.

“TIAs and strokes occur on a continuum,” Dr. Geraghty says. “If the blockage is temporary and blood flow is restored before the brain cells die, then that’s a TIA. If the brain cells die, then that’s a stroke.”

TIA and stroke symptoms

Stroke and TIA symptoms are the same, except TIA symptoms last less than 24 hours, sometimes only a matter of minutes.

The abbreviation BE FAST describes the common signs of a TIA or stroke and what to do:

B = Balance: Sudden changes in balance; trouble walking
E = Eye: Sudden changes in vision, such as blurry vision or loss of vision in one eye
F = Face: Droopy face or unevenness on one side of the face
A = Arm: Inability to raise both arms; one arm hangs down, feels weak or numb
S = Speech: Slurred speech or difficulty speaking
T = Time: Call 911 now if any of these signs are present

What happens if you have a TIA

While TIA symptoms may resolve on their own, you shouldn’t ignore them. About one-third of people who experience a TIA will go on to have a stroke within a year, according to the American Stroke Association, so it’s critical to seek immediate medical attention.

“A TIA gives you an opportunity to jump in quickly and prevent a stroke,” Dr. Geraghty says. “So don’t wait to get care. Anyone who abruptly experiences a new symptom, whether it’s on the BE FAST list or not, should go to the emergency department for an evaluation.”

At the emergency department (ED), your care team will conduct tests to rule out the possibility of a stroke or other neurological conditions. Those tests may include a CT scan, MRI and bloodwork, among others.

Next, the team will evaluate your risk for experiencing a stroke over the next 90 days or less, which will help determine next steps.

“While strokes can be deadly, they more often lead to disability that can rob people of their independence,” Dr. Geraghty says. “So we want to do whatever we can through medications or lifestyle adjustments to lower your chances of experiencing a stroke.”

How to prevent a TIA

The risk for strokes and TIAs increases with age. The American Stroke Association reports that stroke rates double every 10 years beyond the age of 55, but anyone can experience these health events.

“Over the past several years, there’s been an increase in both strokes and TIAs in younger populations,” Dr. Geraghty says. “Sometimes even 20- to 30-year-olds experience them. I think a lot of it has to do with increases in sedentary lifestyles, high blood pressure and diets high in processed foods.”

While the risk for TIAs and strokes does run in families — your risk increases if you have a first-degree relative who has experienced a stroke or TIA — there are steps you can take to prevent these health emergencies.

Manage your blood pressure. Controlling high blood pressure is the most important step you can take to lower your risk of strokes and TIAs. Start by knowing what your blood pressure readings should be and then take action to lower high blood pressure by eating a healthy diet, reducing sodium intake and managing stress, among other tactics.

Be active. Engaging in regular physical activity that you enjoy supports both your physical and mental health — and it doesn’t have to be strenuous. “Even walking three times a week for 20 minutes at a time can significantly reduce your risk of stroke,” Dr. Geraghty says.

Stop smoking. Research indicates that cigarette smoking is responsible for up to 18 percent of strokes in the U.S. and other Western nations. There are many community resources available to help you quit tobacco.

Eat more fiber. A high-fiber diet is associated with a lower risk of experiencing stroke, high blood pressure, diabetes and obesity. Fiber primarily comes from fruits, vegetables, whole grains, nuts and legumes; daily recommendations vary according to age and sex. Ask your doctor or other health care provider for guidance about how much fiber you should be eating.

Healthy Living
Stroke & Neurosciences