TIA and Minor Stroke

Getting a diagnosis of transient ischaemic attack (TIA)

An adequate blood supply is vital for the brain to function. The blood supply carries oxygen, glucose and other nutrients and removes waste products such as carbon dioxide. Four large blood vessels carry oxygenated blood up into the head – two either side of the windpipe at the front of the neck (carotid arteries) and two along the top of the spine (vertebral arteries). If a blood clot or other debris clogs one of these blood vessels (or one of their smaller branch vessels), the blood to the nearby brain cells may be disrupted. If the disruption is only temporary (causing symptoms that last up to 24 hours) it will be diagnosed as a TIA, whereas if symptoms are more permanent, it is diagnosed as a Stroke. Sometimes a TIA occurs when a blood clot from a blood vessel in another part of the body, or from the heart, moves upwards into one of the brain’s arteries. This is called an embolism. Very rarely, symptoms of a TIA are due to bleeding (haemorrhage) in the brain (see resources for more information)
 
Once help was sought most of the people we interviewed had had it explained that the symptoms they were experiencing were typical of a TIA or stroke – slurred speech, weakness in limbs or visual disturbance (see ‘Symptoms’), and in most cases people were told to take aspirin straight away if a TIA was suspected. In some cases the suspected diagnosis was given by the ambulance crew or paramedics who attended the patient following a 999 call.
 
Sometimes people had gone to see their GP to report their symptoms; some people went immediately because they realised that this might be some kind of stroke, but not everybody recognised their symptoms as being those of a stroke or TIA and so delayed going to see the GP (see ‘Seeking help – routes to care and ‘Delay in seeking help ‘). In most cases, the GP said that it was suspected TIA and then referred the person to the TIA clinic or stroke assessment unit for a specialist assessment. Tests will be undertaken to help support the diagnosis and they also help the doctors to assess future risks. Martyn rang his GP and described his symptoms and was told to take aspirin immediately as the doctor thought it sounded like a TIA.
 
Many people we interviewed were given the initial diagnosis that they had had some kind of stroke, and most understood at least partially what that was, however not everyone had heard the terms ‘TIA’, ‘mini stroke’ or ‘minor stroke’ before.
 
Not everyone was given a correct initial diagnosis. Gillian’s doctor initially thought she had a urine infection but Gillian had an idea that it was a stroke and felt it was important to get a proper diagnosis and treatment. Michelle (below) reported her symptoms to the GP several times but he thought her symptoms were to do with anxiety and did not follow through on treating her for TIA. Some months later she had a full stroke and it was only at that time that the symptoms she had reported to her GP previously were suspected to have been those of a TIA.
 
One woman, Susan, who also had a lot of different medical conditions reported her symptoms to a GP who advised her to take aspirin which made her think she had been diagnosed with a TIA, but later other doctors that she saw did not agree with that and she has been left trying to get a definite diagnosis. Sometimes there are no causes found for ‘transient events’ which can feel frustrating for patients.
 
Once an initial diagnosis had been made most people went to the hospital for further assessment (see ‘Tests and scans). Depending on the severity and length of time symptoms persisted, people were either admitted to hospital for these tests to be carried out, or were referred to an outpatient clinic or specialist unit where a consultant would confirm the diagnosis. Different doctors used different terms for their diagnosis and it could sometimes be difficult to know what the difference was between a TIA, a ‘minor-stroke’ or a ‘mini –stroke’.
 
In some cases it was not possible to give a definite diagnosis and some people we spoke to were still waiting for further tests or appointments to continue looking into things.
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Gilly has still not had a definitive diagnosis after several months because she has not yet been sent an appointment to see the neurologist and she feels very let down.
 
People reacted differently to being diagnosed with a TIA or minor stroke (see ‘Emotions and feelings’) Some people saw it as a timely warning sign, a ‘wake- up call’ and were glad to have the opportunity to try to prevent anything more serious happening but some people felt shocked to be told they had had a minor stroke, particularly younger people who had thought that strokes only affected the elderly. When Clare was told she had had a TIA she remembers saying to the consultant “But I’m just a baby, I’m only 48…… Why? Why had I had a stroke?”


Last reviewed August 2013
Last updated August 2013

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