By: Kathy Hubbard
T.I.A.s. Transient ischemic attacks. Should be called mini-strokes, and many physicians do. The word “ischemic” means that there’s a reduced blood flow to a part of the body. With a T.I.A. it’s the brain that’s affected most likely by a blood clot or by other particles in the blood vessel.
“T.I.A. differs from a stroke because it’s temporary – with symptoms usually resolving within an hour but sometimes lasting anywhere from just a few minutes to 24 hours – and it does not cause lasting brain damage,” Yale Medicine’s website says.
But an article in the New York Times on May 17 quotes experts in the field who studied the long term effects of T.I.A.s and conclude that there can be lasting effects specifically regarding cognitive skills.
First, let me explain that the symptoms of a T.I.A. come on suddenly and can include weakness, numbness, or paralysis of an arm or leg, especially on one side of the body; face numbness or drooping; confusion or trouble speaking or understanding speech; dizziness; trouble seeing in one or both eyes, and balance problems.
Although the symptoms go away quickly – often as quickly as they come on – it is still a medical emergency. Do not drive. Call 911. I’m sure every ER provider will tell you that they would rather see you now, even if you’re not having a T.I.A., than in a few days, weeks or months when you’re having a stroke.
I’m not kidding. The chances of having a stroke within 90 days following a T.I.A. is as high as 20 percent, with almost half of those strokes occurring within two days of the T.IA., so says the American Heart Association and the American Stroke Association.
Now back to the Times article. They reported on a large epidemiological study that was published in the Journal of American Medical Association by researchers at the University of Alabama Birmingham regarding the cognitive effects of having a T.I.A. versus having a stroke.
“Over five years, study participants’ performance on cognitive tests after a T.I.A. drops as steeply as it does among victims of a full-on stroke,” the article said.
Dr. Victor Del Bene, a neuropsychologist and lead author of the study was quoted as saying, “If you have one stroke or one T.I.A., with no other event over time and no other change in your medical status, the rate of cognitive decline is the same.”
It goes on to quote Dr. Eric Smith a neurologist at the University of Calgary who wrote an accompanying editorial titled “Transient Ischemic Attack – Not so Transient After All!” He said that “T.I.A.s set people on a different cognitive slope later in life.” And that a T.I.A. can cause “a long-lasting change in people’s cognitive ability, possibly leading to dementia.”
The study is interesting because it analyzed data from three groups of more than 30,000 participants, all over age 45, none with a history of stroke or T.I.A. They then separated those who went on to have a T.I.A., or stroke, or remained asymptomatic.
Dr. Del Bene said that they don’t see an abrupt change in cognition immediately after a T.I.A. The stroke group, however, showed a steep decline. But five years later it was a different story.
“People who had experienced T.I.A.s were cognitively better off than those who had suffered strokes, but both groups were experiencing cognitive decline, and at equally steep rates. It’s not dementia,” he said, “it may not even be mild cognitive impairment. But it’s an altered trajectory.”
In summary, even a slight T.I.A. left untreated can result in long-term cognitive impairment. Just another reason to make sure you know the warning signs and to seek emergency care as quickly as possible. No, don’t wait until the next day to “see how you feel.”
Remember the acronym BE FAST. It stands for balance loss, eyesight changes, facial drooping, arm weakness, speech problems and time, as in, don’t waste any. Bonner General Health’s Emergency Department is open 24 hours a day, 365 days a year.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com. This article was written for publication in the Bonner County Daily Bee on May 29, 2025.
