TIA Assessment

Everything you need to know

A transient ischaemic attack (TIA) happens when the blood supply to part of the brain is temporarily disrupted. This in turn causes a lack of oxygen to that area of brain and can causes symptoms similar to that of a stroke, such as:

• Drooping in the face and/or arm
• Speech difficulties, such as slurring, not being able to speak, or having problems understanding
• Blurred or double vision
• Loss of coordination, clumsiness or dizziness
• Numbness or weakness in the face, arms, or legs
• Nausea and vomiting

Unlike a stroke, as the loss of blood supply is temporary, symptoms will usually disappear within 24 hours, and most within minutes.

Important

A TIA, just like a stroke, is a medical emergency. If you spot the signs of a TIA in yourself or someone else, call 999 straight away. If the symptoms resolve, no matter how quickly, call 999 anyway – having a TIA is a sign that your risk of a stroke is much higher than normal.

What happens next?

When symptoms of a TIA occur, it is vitally important to be checked over and assessed by a specialist doctor as quickly as possible. The risk of a stroke is highest in the immediate period after a TIA, so the sooner you are diagnosed and treated, the more significantly your risk of a stroke is reduced. Indeed, a large observational study found that the risk of stroke reduced by 80% in those treated after a TIA.*

Many conditions look like a TIA (mimics).  It is all the more important to ensure a correct diagnosis is made given that a diagnosis of TIA often has long-standing and far reaching consequences.

“Stroke consultants at Saint John and Elizabeth Hospital have leading roles and decades of experience working in busy NHS hyper acute stroke centres as well as running busy NHS TIA clinics”

After you call 999, you may be taken to hospital or be referred for ongoing investigation and assessment by the NHS. You may also be given Aspirin to help reduce your risk of stroke. It is important that you do not drive if you suspect a TIA or stroke.

You may choose to have your initial rapid assessment and follow-up work at St John & St Elizabeth Hospital. TIAs can happen for a number of reasons, nearly 20% of people who have a TIA will have a stroke within 90 days. This is why it is so important to have an assessment to determine the underlying cause.

Our TIA Assessment:

*Patients who require MRI will be scanned within 24 hours, Patients seen after 3pm on Friday and the weekend, will be offered an appointment on the next working day.

There are times when initial investigations definitively point to a specific cause of a TIA or stroke. For example, an artery leading to the brain that has narrowed and is restricting blood flow. In these cases, we may recommend you have urgent surgery to treat the issue. At St John & St Elizabeth Hospital, we have an excellent vascular surgical team who will be able to guide you through your next steps.

Our TIA Analysis Package:

Ongoing support with our expert team

St John & St Elizabeth Hospital’s Stroke Clinic is supported by full-time dedicated stroke consultants, vascular surgeons, cardiologists and interventional neuroradiologists, as well as a multi-disciplinary Therapies Department that includes Physiotherapists, Occupational Therapists, Speech and Language Therapists and Dieticians.

Whatever your needs following a suspected TIA or stroke, we can provide ongoing support and expertise.

Hypertension (high blood pressure)

High blood pressure is the single biggest risk factor for TIA and stroke. In fact, it plays a part in half of all strokes. Most people with hypertension don’t have any symptoms – this is why you should regularly check your blood pressure. However, if you have very high blood pressures, you may experience headaches, blurred vision, chest pain, difficulty breathing, buzzing in the ears and nosebleeds.

Atrial fibrillation 

Atrial fibrillation is when the heart beats in an irregular fashion. This can cause blood to pool in one of your heart’s chambers instead of flowing through. Clots are then more likely to form that can travel through the carotid arteries into your brain.

Atrial fibrillation can cause symptoms such as palpitations, shortness of breath and dizziness but can also have no symptoms. For some, the first sign they have atrial fibrillation is a TIA or stroke.

Our TIA rapid assessment package includes an ECG which looks for signs of atrial fibrillation. If this is found, we will offer you medication that can reduce your risk of stroke by 62-72%.

If our TIA rapid assessment diagnoses a TIA or stroke and initial investigations did not indicate atrial fibrillation, you can choose to have our supplementary TIA analysis package, which includes a 14-day heart monitor. This is more likely to pick up if there is an underlying atrial fibrillation that may have caused your TIA.

Carotid stenosis

The carotid arteries are the two major arteries (one on the right and one on the left) that supply the front of the brain with blood. Narrowing of the carotid arteries (carotid artery stenosis) has been shown to be a major cause of TIA and stroke.

The carotid arteries can become narrowed due to a build-up of plaque, which is formed of fats, cholesterols and other substances that collect on the inner walls of the arteries.

In a TIA caused by carotid stenosis there is evidence that the plaque becomes unstable and bursts, causing a blood blot. This plaque is at risk of further rupture, which can result in more serious and disabling strokes.

As part of our TIA rapid assessment package, we will scan your carotids within 24 hours of your initial consultation. If carotid artery stenosis is diagnosed, we will start appropriate treatment immediately and arrange an appointment with a vascular surgeon who can definitively manage the issue, thus minimising your risk of a stroke.

At times, a rare cause of carotid stenosis can be found such as a carotid web (a flap of tissue that projects out of the artery’s inner lining). If this is the case, our vascular and stroke consultants have extensive experience in these rarer causes of carotid stenosis and will provide you with a tailored plan to manage your risks.

High cholesterol

Cholesterol is a vital substance in our bodies. However, if there is too much cholesterol in your blood it can clog up the arteries with fatty deposits and lead to a clot forming. Eating a healthy diet low in saturated and trans fats can help reduce your cholesterol levels. However, if dietary changes alone are not having an impact, we may prescribe statins or another type of cholesterol-lowering medicine.