How Do You Treat a TIA, and Does Having a TIA Increase the Risk of a Bigger Stroke Later?

7 answers | Last updated: Nov 05, 2016
A fellow caregiver asked...

What's the recommended treatment following a TIA, and does having a TIA increase the risk of having a bigger stroke?

Expert Answers

Jeremy Payne, M.D., is the medical director of Banner Good Samaritan Stroke Center in Phoenix, Arizona.

There's no treatment needed for the blood clot that causes a TIA, since a TIA, or transient ischemic attack, is a temporary condition that doesn't cause lasting damage. (Also sometimes called a "ministroke," TIA is the term for a blood clot that went to the brain but dissipated without damaging the brain.)

But we still have to figure out what's going on that caused the TIA in the first place. The doctor will probably order a number of scans to check the health of the heart and look for plaque in the arteries. It's important to pay particular attention to the carotid artery, since a weakened carotid artery can cause a major stroke.

In many cases, doctors never pinpoint the exact cause of a TIA, just as they often don't find the cause of a stroke. However, anyone who's had a TIA is automatically in a higher risk category for stroke, and the doctor should evaluate all aspects of the health of his heart and arteries. Since doctors often don't find one cause of a TIA, we take the approach of looking at all the risk factors and shaving off some of the risk in all the categories we can. Risk factors include age, family history, and smoking; then we test blood pressure, cholesterol, and other indicators.

If you're a smoker, you'll be advised to quit. Those with elevated blood pressure will be prescribed medication to lower it, as hypertension increases the risk of stroke by four or five times.

However, many doctors prescribe blood pressure medication even for those in the normal range after a TIA. The same goes for statins (drugs used to lower cholesterol) -- many doctors now recommend a statin as a preventive measure for anyone who's had a TIA. The reason for this conservative approach is that once you've had a TIA, you're automatically considered to be in a higher risk category, so the approach to treatment changes. There's lots of evidence that the more we lower peoples' blood pressure, the better, and that lower cholesterol is also better for anyone who falls in the high risk category.

As far as risk for future stroke, the standard statistic is that anyone who's had a TIA has a 15 to 20 percent increase in their risk of a future stroke. But it's important to realize that most of the elevated risk occurs very soon after the TIA. For example, while it's true that the risk of having a major stroke is elevated by 15 to 20 percent, statistics show that most of that risk applies to the first week after the TIA.

To put it even more clearly, 1 in 20 will have a stroke within a week after a TIA, and half of those will have it within the first 24 hours. Once that window of danger has passed, the risk keeps dropping over time.

And the more you control the factors that contribute to stroke risk, the more you lower the risk.

Community Answers

Terrygay answered...

I would like to congratulate Caring for publishing the first comprehensive and useful answer on TIA "treatment"  I've seen in 20 years--and I've been looking. The public is perpetually advised to go to the emergency room ASAP if they have stroke symptoms, but if they've had a TIA, it tyipically has passed by the time they get there and they receive essentually no treatment--this has happened to at least a half dozen people I know, two of whom subsequently died of stroke at home.The public is TOTALLY in the DARK about TIA's.  Much more information needs to be put out to the public on this topic. The information on statin and BP medication is very helpful.  My guess is that few patients are getting this now.

A fellow caregiver answered...

I agree! A friend of mine, age 47, went to a chiropractor recently. Driving on to her next meeting, she got dizzy, and could not talk coherently. She was barely able to get to an emergency room. After about an hour, they diagnosed her with an anxiety attack, and gave her a brown paper sack to breathe into. More than an hour after that, they realized she'd had a TIA, caused by the adjustment from the chiropractor. Telling her she'd be fine, they sent her home the next day, and she died in her sleep from a stroke that night. Yes, her family has a good lawyer. Not only does the public need to be informed, it appears many medical practitioners do, too!

A fellow caregiver answered...

I would still like to know if or when a TIA can be diagnosed. Basically, what are the signs or symptoms? I have had two spontaneous subarachnoid hemmorhages, and two times of passing out (without any pre-signal, which I would have with fainting). My father used to say he had a stroke, but I dont know for sure. He had high blood pressure and both he and I had, still do, migraines. I believe he, and maybe me too, may have had TIA's, but dont know what to watch for. Can you help me please. My father lived fairly well until he was 90.

Emily m. answered...

Hi Anonymous, good questions! I recommend you ask your question in our Ask & Answer section here: ( I hope that helps -- Emily

Littledove41 answered...

I agree there's not enough information not only for patients but for doctors as will. I to suffered a tia with a seziureI have the small hole in my heads to prove it .it has be five yrs. now I have don't have seizure/tia,s like I did but its taken alot of trial and in medication along the way some Drs. have never heard of having these where you slip from one to a nother but even tho it may be rare it happens so I guess my guestion is it possable that I will have another major one with my Tia's I go to sleepI was in and ofcomafor1and a half weeks I do have membroy lose

Diesel51 answered...

I had two TIA's back in Sept. of 2010, my doctor had ordered extensive test of my circulatory system finding no blockages,blood pressure is low and weight is fine.I exercise and eat all the right stuff ! My Neurologist ordered blood work, the results showed that I have a genetic disorder of very high protein in my blood causing the clot, I am now taking baby aspirin (81 mg.) & 5 mg. of Simvastatin.