What You Need to Know about TIAs

Excerpted from “Why Rush?”, Stroke Connection January/February 2009

While transient ischemic attack (TIA) is often labeled “mini-stroke,” it is more accurately characterized as a “warning stroke,” a warning you should take very seriously.


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TIA is caused by a clot; the only difference between a stroke and TIA is that with TIA the blockage is transient (temporary). TIA symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes; the average is about a minute. Unlike a stroke, when a TIA is over, there’s no permanent injury to the brain. View a detailed animation of TIA

The warning signs of a TIA are exactly the same as for a stroke:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body

Sudden confusion, trouble speaking or understanding

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance or coordination

Sudden, severe headache with no known cause

Why do some clots dissolve while others don’t? According to Dr. Emil Matarese, director of a primary stroke center at St. Mary’s Medical Center in Langhorne, Pa., the body has naturally occurring clot-busting agents. “Eventually all clots will dissolve, but whether there is damage depends on how long the clot is in place,” Dr. Matarese said. However, because there is no way to predict when a clot will dissolve on its own, time is of the essence. “Whenever you have stroke symptoms, dial 9-1-1 immediately and get to the emergency room so you can be evaluated. Don’t wait to see if the symptoms go away.”

While the vast majority of strokes are not preceded by TIA, about a third of people who experience TIA go on to have a stroke within a year. “TIA is a warning stroke and gives a patient time to act and keep a permanent stroke from occurring,” Dr. Matarese said. “By recognizing TIA symptoms and getting to the hospital, the patient can get help in identifying why the TIA occurred and get treatment — either through medication or surgery — that can prevent a stroke from occurring.”

If a survivor experiences TIA after they have had a stroke, they should go to the emergency room immediately because something in their treatment plan has not worked.

In essence, according to Dr. Matarese, there should be no difference in response to a TIA or a stroke. Although a TIA resolves itself before there is damage, there is no way to predict which clots will dissolve on their own. Stroke — and TIA — are medical emergencies; dial 9-1-1 and tell the operator you think it’s a stroke and note the time the symptoms started. Remember: Time lost is brain lost.

This content is reviewed regularly. Last updated 08/25/09.

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