Transient Ischaemic Attack
EDP column by Dr Ketan Dhatariya

“My GP told me I have had a mini-stroke after I temporarily lost my speech. What is this?”

You are correct, a particular brand of insulin, Mixtard 30®, is being withdrawn in the UK from the 31st of December 2010.

A mini-stoke is also known as a transient ischaemic attack, or TIA. It is transient, because the symptoms would have lasted less than 24 hours. Ischaemia is the word used to describe when a part of the body is deprived of oxygen. It is a condition that should be taken very seriously because it can be a warning that other problems may occur. 

A TIA occurs when part of the circulation to the brain is blocked off for a short time. You may have heard the term ‘hardening of the arteries’. This is where the blood vessels are coated with a fatty layer, made up of cholesterol. Unlike the term used to describe it, this layer can be quite soft and ‘flaky’. If a small part of this soft layer flicks off, it travels in the blood stream. It then comes to rest when the blood vessel it is trying to get through is smaller than the piece of fatty layer. This blocks the blood vessel, depriving everything downstream of blood, and oxygen – thus making it ‘ischaemic’.

If the blood vessel being blocked is in the brain, then the brain cells being deprived of oxygen die off and lose their functions. Depending on what part of the brain is affected, determines the symptoms you get. For example if the part of the brain affected is important in vision, then you may lose your sight, or if is the part allowing you to lift your left arm, then it may go weak.

Luckily, the body is able to mount a defence against small blockages and often the blood supply can get around the blockages, thus making them ‘transient’, if symptoms last for less than 24 hours.  If they last for more than 24 hours, then it is known as a stroke.

These episodes can be prevented. The most important thing is not to smoke. Also, get your blood pressure checked and make sure that if your GP says it is high, then to take the treatment they recommend. Also you will probably benefit from having your cholesterol lowered. If you have diabetes then good diabetes control is important. A good diet and plenty of exercise also helps prevent these from occurring.

Mini-strokes may be a warning that a bigger stroke may be on its way. In 9 out of 10 cases this is not always the case, but it is important to look after yourself to try and prevent things from getting worse.

If you have any questions, then as always, go and discuss these with your GP.

For more information about TIA/Transient Ischaemic Attack click these links: