(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)
Dear Doctor: While my wife and I were working in the garden, she got dizzy and couldn't understand what I was saying. It went away after a few minutes, but I took her to the ER anyway. The doctors said she had a TIA. What is that, and is it dangerous?
Dear Reader: Your wife experienced a transient ischemic attack, or TIA. Also known as a mini-stroke, a TIA happens when part of the brain is temporarily deprived of blood flow.
You were right to seek immediate medical help. The symptoms of a TIA and those of a major stroke, which is the fifth-leading cause of death in the United States, are quite similar. And though the effects of a TIA are temporary -- that's the "transient" in the name -- that doesn't mean they're harmless.
First, let's talk about what's going on.
Ischemic strokes occur when a blood vessel in the brain becomes blocked, often by a blood clot. As a result, the part of the brain that is fed by that vessel is starved of blood. Since blood carries oxygen, which is vital to survival, it takes just a few minutes for brain cells to begin to die.
Unlike in a major ischemic stroke, where the blockage persists and damage can be permanent, a TIA resolves quickly. Sometimes it takes just a few minutes, and sometimes the effects can last up to 24 hours. When the TIA is over, the person feels normal again.
Symptoms of a TIA include the dizziness and cognitive lapse that your wife experienced. Additional symptoms may be a sudden headache, impaired vision, numbness or weakness in the face or limbs, garbled speech, and loss of balance and coordination.
The federal Centers for Disease Control and Prevention classify a TIA as a medical emergency. Although impairment due to a TIA is temporary, the event itself is a warning sign that needs to be addressed. A person who has experienced a TIA is at increased risk of a full-blown stroke, particularly in the first few days after the attack. However, with prompt treatment, as well as certain lifestyle changes, you can decrease the chance of a future stroke.
Your wife should see her primary care physician to discuss what happened and to begin treatment. This typically includes taking aspirin, a blood thinner that makes your platelets less likely to clump together. Aspirin should be initiated and continued under a doctor's supervision.
The good news is that your wife can also make some simple lifestyle changes to decrease her risk of another episode:
-- Keep blood pressure under control.
-- Don't smoke, and avoid secondhand smoke.
-- Maintain a healthy weight.
-- Eat plenty of fresh fruits and vegetables.
-- Exercise regularly.
-- Avoid stress.
-- Get enough sleep.
-- Limit alcohol.
Even better news: Every one of these suggestions will make you healthier, too.
(Send your questions to firstname.lastname@example.org, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.)