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Transient Ischemic Attack is also known as TIA by the medical professionals but in layman’s term, they usually call it as “mini stroke” or “stroke like illness”.  The only difference of TIA with stroke is the time frame as well as the absence of tissue death or infarction. Compared with stroke which has a more debilitating effect, TIA only occurs for about 1 to 2 hours and the patient will eventually go back to its original state of mind and body.

It is usually described with occurring neurological dysfunctions that resemble stroke, like numbness and paralysis. This happens when there is a clot in a specific part of the brain that prevents blood flow to the brain and the symptoms will depend on which part of the brain was affected. But, after some time, this clot will be dislodged and blood will be flowing again to that part of the brain thus the person affected will go back to its normal condition again. Sometimes, symptoms occur for only 30 minutes and is sometimes, taken for granted.

TIA might be considered as a warning sign of possible stroke in the future, if no proper medications are given to the patient. This is a sign of a cerebrovascular disease that must be diagnosed and managed well to prevent significant morbidity and mortality.

Causative Factors

  • Cigarette Smoking
  • Thromboembolism
  • Diabetes Mellitus
  • Increase Age
  • High Cholesterol Diet
  • Sedentary Lifestyle
  • Hypertension
  • Stress

Anatomy and Physiology

There are two systems of the body that are affected by this type of disease. The Circulatory and the Nervous System specifically the central nervous system which includes the brain and the nerves.

The circulatory system is the system responsible to fuel the different organs with blood and oxygen. It also carries carbon dioxide and other wastes to be released from our body for this will serve as toxins in the long run.

The heart, the blood and the blood vessels (arteries, veins and capillaries) are all part of the circulatory system which main purpose is to keep the blood flowing in the different parts of the body including the brain. Any obstruction to the blood flow can present problems which can be very evident if it happens in the brain since it is the main control system of the body.

The brain is the main part of the central nervous system and is where the control system of the body. It signals different organs to perform its own duty. Any disruption to the brain blood flow can mean death if not immediately taken care of.

Our brain consists of different parts which also has its own roles and function. The cerebellum is concerned with the coordination of movement of the motor learning. The medulla controls breathing and some reflexes that help the organism maintain an upright posture. The cerebral cortex is responsible for the primary motor, somatosensory, visual, auditory and association areas. Therefor any alteration in a specific part of the brain will also mean disruption of its main function.

Another part of the nervous system which serves as the communication system of the body are the nerves which are scattered all over our body. The brain would signal any command and  nerves are the one responsible to communicate it with the specific part of the body.

Pathophysiology

Clinical Manifestations

  • Fleeting blindness
  • Contraleral weakness
  • Vertigo
  • Diplopia – double vision
  • Numbness
  • Paresthesia
  • Dysphagia – difficulty of swallowing
  • Ataxia

The clinical manifestations will depend on the location of the affected vessel in the brain.

Assessments and Diagnostic Examination

The following are some diagnostic procedures that will allow proper visualization of the vessels affected.

  • Carotid angiography (which is the most commonly used diagnostic exams) –a procedure used to visualize intracranial and cervical vessel
  • Carotid phonoangiography – this will allow direct visualization of the carotid bruits
  • Digital subtraction angiopraphy – usually used to see obstructions in the carotid artery
  • Oculoplethysmography – this measure pulsation in blood flow through ophthalmic artery

Pharmacological Management

1. Acute Treatment:

  • Thrombolytic therapy – use to dissolve clot that is obstructing the blood flow
    • Example: Activase

2. Stroke Prevention

  • Anticoagulant therapy – used to prevent further attack by preventing thrombus formation.
    • Example: Aspirin, Warfarin, Clopidogrel

Surgical Management

  • Endarterectomy : procedure used to remove plaque in the lining of the artery
  • Angioplasty : surgical procedure where they use a balloon catheter to widen the obstructed artery thus increasing blood flow.

Complications

  • If not manage well, it will eventually lead to stroke thus make lead to death

Nursing Management

Promotive and Preventive

  • Will revolve mostly on how to promote healthy lifestyle and prevent stroke occurance in the future
  • Nurses must make sure to keep the patient eat a healthy diet and make a list of the foods that they should avoid like foods high in cholesterol.

Curative

  • Nurses should make sure that the patient comply with the medication procedure.

Discharge Plans

  • Maintain a low salt low fat diet
  • Avoid Smoking and Inhaling second hand smoke as well
  • Maintain Blood pressure within normal limits; Monitor blood pressure always
  • May teach patient’s family on how to take Bloop pressure correctly
  • Exercise regularly
  • The patient must be able to assess subtle signs of neurological dysfunction such as difficulty of swallowing, hoarseness of voice, simple chest pain, dyspnea etc.
  • If any symptoms occur again, instruct the patient as well as the family to bring the patient to the nearest health care facility.

Transient Ischemic Attack may seem to be less harmless than a stroke nevertheless, this shouldn’t be taken for granted for this may lead to much more life threatening results. This should be managed well and the patient should take care of what they eat and their lifestyle must be improve immediate response is needed when those symptoms occur. Prevention will always be better than cure.

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I'm Trixie (@iamtwixietops) and I'm a Registered Nurse/ Blogger who works in a BPO company, usually works at night and struggles to find some random things to do during the day. Loves hanging out in coffee shops, book stores, library, going out with friends and messing up with her sisters. I am not a writer but writing is one of my stress relievers. http://www.trixiericablanca.org/