Transient ischemic attack (TIA)

When to seek medical advice

See your doctor if you suspect you may have had signs or symptoms of a TIA. You'll need an immediate medical evaluation to determine what caused the problem. It's important to identify the cause so that you can take steps to prevent a stroke.

Screening and diagnosis

Characteristics of a TIA include its rapid onset, short duration and your body's return to its normal state. Your doctor may diagnose a TIA based just on the medical history of the event rather than on anything found during a general physical and neurologic examination.

In some people who've experienced a TIA, a physical examination may reveal evidence that suggests the presence of arterial plaques. Your doctor may hear a sound (bruit) over the carotid artery in your neck during an examination. Or your doctor may observe cholesterol fragments (emboli) in the tiny blood vessels of your retina, at the back of your eye, during an eye examination using an ophthalmoscope.

These tests also may help diagnose the cause of a TIA:

• Carotid ultrasonography. A wand-like device (transducer) sends high-frequency sound waves into your neck. After the sound waves pass through your tissue and back, your doctor can analyze images on a screen to look for narrowing or clotting in the carotid arteries.

• Computerized tomography (CT) scanning. CT scanning of your head uses X-ray beams to assemble a composite, three-dimensional look at your brain.

• Computerized tomography angiography (CTA) scanning. CT scanning of the head may also be used to noninvasively evaluate the arteries in your neck and brain. CTA scanning uses X-rays, similar to a standard CT scan of the head, but may also involve injection of a contrast material into a blood vessel.

• Magnetic resonance imaging (MRI). This procedure, which uses a strong magnetic field, can generate a composite, three-dimensional view of your brain.

• Magnetic resonance angiography (MRA). This is a method of evaluating the arteries in your neck and brain. It uses a strong magnetic field, similar to MRI.

• Transesophageal echocardiography (TEE). During this procedure, a flexible probe with a transducer built into it is placed in your esophagus — the tube that connects the back of your mouth to your stomach. Because your esophagus is directly behind your heart, very clear, detailed ultrasound images can be created, allowing a better view of some things, such as blood clots, that might not be seen clearly in a traditional echocardiography exam.

• Arteriography. This procedure gives a view of arteries in your brain not normally seen in X-ray imaging. A radiologist inserts a thin, flexible tube (catheter) through a small incision, usually in your groin. The catheter is manipulated through your major arteries and into your carotid or vertebral artery. Then, the radiologist injects a dye through the catheter to provide X-ray images of the arteries in your brain.

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