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A mini-stroke may be sign of a major underlying health issue

Q: 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?

A: 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.

• Dr. Eve Glazier is an internist and assistant professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and primary care physician at UCLA Health.

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