Transient ischaemic attack

Also called TIA, Mini-stroke

Stroke symptoms that resolve within 24 hours. The warning, not the escape.

What it is

A transient ischaemic attack is a temporary blockage of blood supply to part of the brain. Symptoms are identical to a stroke and they resolve, usually within minutes.

The nickname mini-stroke is actively harmful, because it implies something small happened and it is over. What actually happened is a warning, and the risk of a full stroke in the following days is high enough that NICE requires specialist assessment within 24 hours.

Around one in twelve people who have a TIA go on to have a stroke within a week without treatment. With prompt assessment and treatment, that risk falls dramatically.

Signs you might notice

Exactly the stroke signs, resolving. FAST applies.

Face dropped on one side. Weakness in an arm. Slurred or muddled speech.

Also: sudden loss of vision in one eye, described as a curtain coming down. Sudden loss of balance. Sudden numbness on one side.

The defining feature is that it goes away, which is precisely why people do not act on it.

How it can affect day-to-day life

The pattern that costs lives is entirely predictable: symptoms resolve, the person feels foolish about making a fuss, they decide to mention it at their next routine appointment, and they have a stroke before it.

TIAs are also commonly mistaken for a funny turn, a dizzy spell or a migraine, particularly in older people, and get dismissed by everybody involved.

For anyone with atrial fibrillation, a TIA is a particularly loud alarm, because anticoagulation would very likely have prevented it.

Supporting someone well

Act on resolved symptoms. Call 999 or 111 the same day and use the word TIA. Do not wait for a GP appointment next week.

Note exactly what happened and how long it lasted. That detail determines the assessment.

Push for the TIA clinic within 24 hours, which is the standard, and say so if you are offered longer.

Do not drive until you have been assessed and told it is safe. There are DVLA rules.

Afterwards, take secondary prevention seriously: antiplatelets or anticoagulation, blood pressure, cholesterol, and treating atrial fibrillation. This is where the stroke gets prevented.

Where to get help

Call 999 for ongoing symptoms. For resolved symptoms, call 111 or the GP the same day and ask for urgent TIA clinic referral.

Stroke Association helpline: 0303 3033 100.

Repeated TIAs mean the risk is high and warrant emergency assessment.