Transient ischemic attacks, or TIAs, are often called “mini strokes.” Like a stroke, a TIA is caused by an interruption of blood flow to the brain, but the interruption is only temporary and resolves itself within hours. However, because about one-third of people who experience a TIA do go on to have a full-blown stroke, getting the right treatment for your TIA is essential for preventing more TIAs or a stroke in the future. Depending on the cause of your TIA and your medical history, treatment for mini strokes can include lifestyle modifications, medications or surgery – or a combination of these.
What Causes a Mini Stroke?
TIAs, or mini strokes, are caused by a loss of blood flow to certain areas of the brain. That accounts for the stroke-like symptoms characteristic of an attack, including weakness or numbness on one side of the body, trouble with speech or coordination, loss of vision or blurred vision and confusion. But those symptoms can have several causes.
Artery disease, particularly when it affects the large carotid arteries in the side of the neck, can create conditions for a TIA. The hardening or narrowing of the arteries is caused by accumulations of plaque, a substance made up of fatty deposits, cellular debris and other proteins. Plaque buildup can narrow or completely block the artery, and clumps of plaque that break free can migrate to blood vessels in other parts of the body and cause blockages there.
Abnormalities of the small blood vessels in the brain can also cause a TIA. These vessels may be improperly formed or have other structural issues that impede the flow of blood.
Because mini strokes have multiple causes, your doctor will most likely conduct a number of tests, such as computerized tomography, magnetic resonance imaging or an electrocardiogram, to pinpoint the reason for your TIA. These will help to determine the best course of treatment for mini strokes.
Treatment Options for Mini Strokes
A mini stroke is an event, not a condition, so treatment for mini strokes typically focuses on preventing another event from happening. That can include making lifestyle changes, taking medications to manage contributing health conditions or surgery to clear blockages and enhance blood flow to the brain.
Lifestyle Management Reduces Risks
For many people, heart and artery disease are causes of a TIA. Lifestyle factors play a major role in the development of these diseases, so making healthy changes is the first step toward reducing the risk of future events.
Smoking, inactivity, high alcohol use and obesity contribute to the narrowing and stiffening of the arteries. These factors also play a role in the development of high blood pressure, or hypertension, another risk factor for TIA.
Stopping smoking, reducing alcohol consumption and exercising, which encourages circulation and weight loss, can help promote cardiovascular health. These changes can also help to lower blood pressure.
Diet, too, plays a role in reducing the risk of TIA and stroke. A diet high in sugars, unhealthy fats and processed foods contributes to the buildup of plaque in the arteries and to chronic conditions like Type II diabetes and high blood pressure. Your doctor may recommend dietary changes such as reducing salt and sugar intake and eating more plant-based and unprocessed foods as part of your treatment for mini strokes.
Medication: The Next Step
In some instances, lifestyle modifications may be the only thing needed to prevent future mini strokes or strokes. But for some people, medication may also be necessary to support these healthy changes and reduce risk factors.
If diet and exercise aren’t enough to lower blood pressure and cholesterol levels, your doctor may recommend antihypertensive medications such as diuretics and calcium channel blockers, or statin drugs to reduce cholesterol, which is a major component of the plaque that causes the narrowing and blockage of arteries.
In some cases, medications can help lower the risk of blood clots by affecting the consistency and clotting ability of the blood itself. Antiplatelet medications such as aspirin can help to prevent clots from forming, and so can anticoagulant, or “blood thinning,” medications such as Warfarin. Other medications that can help to lower stroke risk include drugs to manage diabetes and other chronic health conditions.
Surgery: A Third Option
When lifestyle and medication, or a combination of the two, aren’t enough to reduce the risk factors for TIA and stroke, surgery may be needed to restore healthy blood flow to the brain. Performed by neurosurgeons specializing in cerebrovascular medicine, procedures such as carotid revascularization and cerebral bypass surgery directly address problems in blood vessels that contribute to TIA and stroke.
Carotid revascularization is a procedure performed on one or both of the large carotid arteries in the neck to remove parts of the artery wall that are affected by plaque. This eliminates the narrowing of the artery and allows blood to flow more normally to the brain.
Cerebral bypass surgery is another kind of procedure performed to reduce the risk of stroke. As the name suggests, the neurosurgeon reroutes blood vessels in the brain to bypass an area that contains abnormalities or damaged blood vessels, so that blood can flow normally throughout the brain.
Anyone who has had a TIA faces a high risk of having a stroke, so treatment that addresses the causes of a TIA and mitigates risk factors is essential. Treatment for mini strokes is unique to each individual, and your doctor will work with you to find the right approach for your situation.
