Important Disclaimer. The following information is provided for your reference only. The statements made here are no substitute for professional medical advice. This information is given in good faith but Delicate declines to accept any responsibility for the accuracy of any statement made. If you have any health concerns we urge you to visit your health professional.
Many professionals feel that the term "stroke" does not adequately describe the condition and prefer the term "brain attack"
What is a TIA?
TIA is short for transient ischemic attack. Transient as in short term and ischemic meaning lack of blood supply. A TIA, therefore is a short term lack of blood to the brain and is often called a mini stroke. TIA is a serious warning sign that you are at increased risk of a stroke.
A TIA is a temporary problem that happens when part of the brain does not get the blood supply that it needs. When the brain does not get enough blood it also does not get the oxygen and nutrients that it needs to work properly. This causes sudden short term neurological problems such as
Weakness
Trouble speaking
Dizziness
Vision problems
Headache
Most TIAs only last a short time from 30 seconds to 10 minutes, although some may last as long as 24 hours. A TIA that lasts only a few seconds does not usually leave any lasting noticeable effects even though some brain cells may be damaged. Minor damage to the brain is often unnoticeable as plenty of healthy cells are left to carry out the normal functions of the brain.
What is a stroke?
A stroke is a sudden loss of brain function. It is caused by a loss of blood flow to the brain (an ischemic stroke) or a rupture of the blood vessels in the brain ( a hemorrhagic stroke) This interruption or rupture of blood vessels causes brain cells (Neurons) in the effected area to die. The effects of a stroke depend on were the brain was injured as well as how much damage occurred. As the brain controls everything we say, do or think, a stroke can have a wide variety of effects. A stroke can effect your
Ability to coordinate movement
Ability to feel and touch
Ability to see and interpret what you see
Ability to think and understand
Ability to communicate
Personality
Emotions
Behavior

What causes a TIA?
A TIA is a temporary lack of blood supply to the brain. This can happen when one of the arteries supplying blood and nutrients to the brain becomes blocked. The part of the brain supplied by that artery will not receive the blood that it needs. If the brain cells do not get enough oxygen and nutrients they start to die. Brain cells die in about 4 to 6 minutes. Several conditions can cause TIAs. The main cause is atherosclerosis or hardening of the arteries. TIAs can also be caused by
Spasms in the arteries of the brain
Abnormalities in the shape of the blood vessels
Inflammation of the arteries
Abnormal blood pressure changes
In some cases doctors are unable to determine the cause
What is Atherosclerosis?
Atherosclerosis is a condition in which fatty material called plaque (atheroma) builds up on the inside wall of the artery. Plaque is a sticky yellow substance made up of fatty substances like cholesterol and blood cell debris. Plaque builds up and damages the thin inner layers of artery walls, causing the artery walls to become thicker and less elastic. The inside of the artery becomes narrower and as a result less blood is able to flow though it. A blood clot (thrombosis) could then develop further narrowing or blocking the flow of blood, a process known as atherothrombosis. A piece of plaque or a blood clot could break off and travel to other parts of the body also blocking off the blood supply. When a vessel supplying the heart is narrowed it can cause conditions such as angina (chest pain) and / or heart attack. A narrowed or blocked vessel supplying the brain can cause a TIA or stroke. When blood supply to the legs is reduced it can cause pain and discomfort in the calves when walking and in more advanced cases when at rest. Treating any of the atherosclerosis related conditions can impact on all of them. Atherosclerosis is a slow, progressive condition that can begin as early as childhood. It can involve all parts of the arterial system including the heart, brain and legs. The older you are the more advanced the atherosclerosis in your arteries is likely to be.How quickly it develops depends on many factors such as your family medical history and your life style.
How does atherosclerosis and clot formation cause a TIA?
Atherosclerosis can make arteries in the neck much narrower. These narrowed arteries will allow little or no blood to flow through. A blood clot or piece of plaque can block the artery completely or the clot can break off, travel to another location and block the blood supply there. Blood clots can form when cells in the blood called platelets clump together. Most often blood clots are caused by atherosclerosis but they can be caused by certain heart conditions. Blood clots can form anywhere in the body including artery walls and heart valves. Most clots that cause TIAs are formed in the carotid arteries in the neck (50 - 60 %). Approximately 25% come from the heart and the rest from other parts of the body. When a TIA occurs the plaque or blood clot clears away on its own. Little or no brain damage occurs and the symptoms go away without treatment. If the brain cells are deprived of their blood supply for a longer period some cells will die causing a stroke.
Damage to a specific region of the brain affects the function controlled by that region. For example damage to the speech region may lead to difficulty talking.

How will I know if I am having a TIA or Stroke
You may be having a TIA or stroke if you experience,

Weakness - sudden weakness, numbness and tingling in the face, arm or legs
Trouble speaking - sudden temporary loss of speech or understanding speech
Vision problems - sudden loss of vision particularly in one eye
Headache - sudden severe and unusual headache
Dizziness - sudden unsteadiness or falls, particularly if you have other warning signs
If you experience any of these symptoms, it is a medical emergency, call 911
Getting to a treatment center quickly is crucial to reducing the damage to your brain. In the past few years major advancements have been made in the treatment of stroke. These new treatments need to be made within a few hours of the onset of symptoms in order to be effective. The doctors must investigate carefully to determine the cause of your symptoms so that you get the correct treatment. Do not try to figure things out for yourself and do not wait for the symptoms to pass. Get to the hospital as quickly as possible. Even if your symptoms go away on the way to the hospital being seen by a doctor is crucial in identifying the underlying causes of your symptoms.
Recognizing the warning signs of a TIA or stroke as soon as they appear and seeking immediate medical treatment gives you the best chance of a favorable outcome.
What are the risk factors for stroke?
A risk factor is something in a person's physical condition or health habits that increases the chance of developing a medical condition such as stroke. A TIA is a serious warning sign that you are at risk of having a stroke. Once you have had a TIA, it is important to do everything you can to reduce your risk factors for stroke. Some risk factors are present at birth, some are the result of normal changes such as aging, and some are the result of lifestyle.

The risk factors that you can't change are:
Age: The risk of stroke and TIA increases with age. Although strokes can occur at any age, most strokes occur in people over the age of 65.
Gender: Although women are at lower risk than men until they reach menopause, more women than men die of stroke. There
are particular risks for women around the time of pregnancy and with the combination of smoking and oral contraceptives.
Ethnic background: Native Americans, African Americans or people of South Asian descent tend to have higher rates of blood pressure and diabetes and are at higher risk for stroke compared to the general population.
Family history of stroke or TIA: If someone in your family has had a TIA or stroke before the age of 65, you are at increased risk of having a stroke. The closer the family member ( e.g. parent) the greater the risk.
You can't do anything about these risk factors. However, if you have one or more of these risk factors, you should take extra steps to make healthy lifestyle choices to prevent stroke.

The risk factors that you can change are:
High Blood Pressure: High blood pressure is also called hypertension. Reducing high blood pressure is very important in reducing the risk of stroke.
Blood pressure is the force of blood pushing against the walls of an artery as the blood is squeezed from the heart. Changes in activity, posture, and emotions can cause changes in blood pressure. These are temporary and normal. Blood pressure that is consistently over 140/90 is considered high. High blood pressure can sometimes be controlled through a combination of proper diet, exercise, and stress reduction. Managing diabetes, being smoke-free and limiting alcohol use are also important. If these methods are ineffective, medications may be prescribed. For the medication to be effective, it must be taken regularly. You should never stop taking blood pressure medication without first consulting your doctor. If you have any questions or experience unpleasant side effects, talk with your doctor. There are often alternatives.
High blood pressure has been referred to as the "silent killer" because there are often no symptoms. The only way to know if you have high blood pressure is to have your blood pressure taken by a healthcare professional at least once every two years.
Blood pressure action plan: Simply see your doctor and get your blood pressure measured.
Become smoke-free: Smoking is the most preventable cause of disease and death in the world. Contrary to what most people believe, smoking causes more deaths from stroke or heart attack than from cancer.
Smoking affects the circulatory system in a number of ways. Smoking adds to the buildup of plaque in your arteries. Nicotine raises your blood pressure. The carbon monoxide in cigarette smoke reduces the amount of oxygen your blood carries to your brain. Cigarette smoke makes your blood thicker and more likely to clot. People who become smoke-free can rapidly reduce their risk for stroke to that of non-smokers. Non-smokers can reduce their risk by avoiding environmental tobacco smoke. Becoming smoke-free is a very difficult process. If you smoke, your doctor can recommend programs and medications that can help you. Yes it is hard and might even seem impossible but it can be done.
Remember, it is never too late to become smoke-free.
Physical inactivity: People who don't have enough physical activity in their lives are at much higher risk for stroke than are active people. More than half of the western world don't get enough physical activity to prevent heart disease and stroke. Regular physical activity raises the level of "good cholesterol" (HDL) in your body. It also makes your muscles more efficient and helps your blood circulation. Physical activity can also help you reduce stress, control your blood pressure, prevent or control diabetes, and maintain a healthy body weight. To reduce your risk of stroke, you should be physically active 30 minutes a day most days of the week. How much exercise you need to do depends on how hard you are exercising -for example, a short run can give you the same benefits of a longer walk. You can get the same benefit from breaking your physical activity into shorter sessions, such as three 10-minute sessions in a day. You can get more information about physical activity by contacting your local Heart and Stroke Foundation. Remember you should speak to your doctor before starting any fitness plan.
Heart disease: Coronary artery disease, heart valve defects, an enlarged heart, or an irregular heartbeat can cause blood clots to form in the heart that may break loose and block the arteries that supply blood to the brain. Your doctor may prescribe medication to help prevent the formation of clots.
Atrial fibrillation: a type of irregular heart rhythm, is strongly linked to an increased risk of stroke. If you have atrial fibrillation, be sure to ask your doctor about anticoagulant medication.
Diabetes: Diabetes mellitus is a condition in which the body doesn't produce or properly use insulin. Diabetes often leads to high blood pressure and high levels of cholesterol in the blood.
People with diabetes are at much higher risk for stroke than is the general population, and women with diabetes are particularly at risk. The risk of stroke also begins at a much younger age for people with diabetes. If you have diabetes, you should eat a healthy diet, perform
regular physical activity, maintain a healthy body weight, and take the medications ordered by your doctor to regulate blood sugar levels and reduce your risk of stroke. Good control of your diabetes is the best way to minimize your risk.
High cholesterol: Cholesterol and triglycerides are fat-like substances that are an important backup source of energy for your body. However, high levels of the wrong types of these fats can contribute to the development of atherosclerosis, leading to TIAs, stroke, and heart disease . Blood cholesterol is made up of HDL ("good cholesterol") and LDL ("bad cholesterol"). HDL carries the cholesterol formed by the body to the liver so it can be eliminated. LDL can be deposited inside the walls of the arteries and help form plaque. Low levels of HDL and high levels of LDL lead to atherosclerosis and increase the risk of stroke and heart disease.
A diet high in fat can result in high blood levels of LDL cholesterol. Most people need to reduce the overall amount of fats in their diet. In fact, fat intake should be below 30% of total calories. In particular, to reduce LDL cholesterol, you should reduce saturated fats. Saturated fats are generally the fats from animal sources that stay in a solid form at room temperature, such as butter, cheese, or the fat around a steak. Harmful saturated fats are also found in palm and coconut oils. Trans fats are another type of harmful fat. Trans fatty acids are formed by a process called hydrogenation where a liquid fat is made into a solid fat. Trans fatty acids are found in many baked goods and certain margarines. (Look for non-hydrogenated on the label to help you make a good choice.)
Polyunsaturated and monounsaturated fats are better choices. Remember, it is important to reduce all fats but the ones you do choose to eat should be largely one of these types. Polyunsaturated fat is found mainly in vegetable oils such as sunflower, corn oil, and margarine made from these oils and seeds. Monounsaturated fats are found in canola, olive and peanut oils as well as in nuts and seeds, although some nuts are high in saturated fats, such as cashews and brazil nuts.
These fats tend to lower cholesterol and may also help the body maintain proper levels ofHDL cholesterol (the "good cholesterol"). High cholesterol levels can be the result of your family history and/or the types of food you eat. Medication, physical activity and diet changes can help lower high blood cholesterol levels. Ask your doctor what you can do to lower your cholesterol level. Recent research has shown that regardless of cholesterol level, lowering the cholesterol level in the blood reduces the risk of stroke.
Excessive alcohol intake: More than 1-2 drinks per day up to a weekly total of 9 for women and 14 for men increases the risk of stroke. Heavy drinking and binge drinking have been clearly identified as risk factors for stroke and are also associated with high blood pressure. One drink is equal to:
350 mL/12 oz. (1 bottle) of beer (5% alcohol) 150 mL/5oz. wine (12% alcohol)
50 mL/1-1/2 oz. liquor (40% alcohol)
Being overweight: Compared to people who maintain a healthy body weight, people whose body weight is more than 20% above a healthy weight have a greater risk of high blood pressure and diabetes. This means they also have a greater risk of stroke. People who are overweight also tend to have other risk factors, such as physical inactivity, diabetes, high blood pressure, and high blood cholesterol levels. To maintain a healthy body weight, enjoy regular physical activity and eat a healthy diet. Most professionals recommend the following guidelines:
enjoy a variety of foods emphasize cereals, breads, other grain products, vegetables, and fruits, choose lower fat dairy products, leaner meats, and foods prepared with little or no fat, limit salt, alcohol and caffeine
Hormonal changes: Modern oral contraceptives (birth control
pills) are much safer than the forms used decades ago. In women under the age of 35 who are smoke-free, their use does not increase the risk of stroke. However, in a small proportion of women, oral contraceptives increase the risk of high blood pressure and of blood clots. The risk is greater if you:
smoke
already have high blood pressure
already have a blood clotting problem
are over age 40
Recent evidence has found that hormone replacement therapy does not reduce the risk of recurrent stroke; more studies are ongoing. Talk to your doctor about the best choice for you.
Stress: Most people have some stress in their lives. However, too much stress may contribute to the risk of stroke, although research on stress is still being done. Stress can cause the heart rate to increase, the heart to pump harder, blood sugar levels to increase, and fats in the blood stream to increase. Continual or frequent stress places more demand on the heart and enhances the development of plaque. Stress often leads to unhealthy lifestyle choices such as:

smoking
high alcohol consumption
lack of physical activity
poor food choices

The first step in reducing and controlling stress in your life is to recognize what is causing the stress and take steps to avoid it. Once you notice how you react to stress, you can start trying to change your reaction. Try different methods to remove or reduce your stress, and learn to manage stress in a healthy way. Some suggestions include participating in regular physical and other enjoyable activities, performing relaxation techniques, sharing feelings, managing your time better, eating a healthy diet, and confronting the person or situation that is causing continued stress.
If you are a health professional and have any comments regarding this page, please contact us.