Warning Signs of a TIA or "ministroke"

By Joel Callahan Jr., M.D.

Pardee Neurology Associates

Pardee UNC Health Care


The signs of a stroke are usually striking and obvious: slurred speech, drooping facial features, difficulty speaking and weakness on one side of the body. But if you temporarily experience these symptoms and then feel completely fine a few minutes later, you may be tempted to ignore them. However, fleeting stroke symptoms can be a sign of a transient ischemic attack (TIA), also known as a “ministroke.”

TIAs are serious because they are a risk factor for a full-blown stroke. The American Stroke Association says TIAs occur before 12% of strokes.

What is a TIA or ministroke?

A stroke and a TIA are caused by the same factors and have the same symptoms. The main difference is that with a stroke, symptoms don’t go away on their own and the person may experience permanent changes in mobility, speech or vision because of brain injury.

Both strokes and TIAs occur when blood flow to the brain is blocked. When the brain doesn’t get enough oxygen-rich blood, brain cells start to die.

A stroke can be ischemic, which means there’s a blockage in a blood vessel in the brain, or hemorrhagic, which occurs when a blood vessel ruptures and blood leaks into the brain. Ischemic strokes are the most common form of stroke.

A TIA occurs when blood flow to the brain is temporarily blocked. That’s why symptoms usually go away after 24 hours and the TIA doesn’t cause permanent brain injury. But a TIA can be a precursor to a full-blown stroke: 9 to 17% of people who have a TIA will have a stroke within 90 days.

TIA and stroke symptoms

A stroke and a TIA have the same symptoms. To remember them, think of the American Stroke Association’s BEFAST acronym:

Balance: Sudden dizziness, loss of balance or coordination

Eyes: Sudden trouble seeing out of one or both eyes

Face drooping: One side of the face may droop or feel numb.

Arm weakness: One arm may become weak or numb.

Speech: Speech may be slurred or difficult to understand.

Time to call 911: If someone has any stroke warning signs, call 911 right away and get them to a hospital. Never attempt to drive yourself to the hospital if you think you may be having a stroke.

Other symptoms include sudden difficulty seeing out of one or both eyes, confusion, numbness (especially on one side of the body), difficulty walking, dizziness, loss of balance or coordination, and a sudden severe headache with no known cause.

TIA and stroke risk factors

While anyone can have a TIA, the risk increases with age. Other risk factors for a TIA and stroke include diabetes, cardiovascular disease (such as heart disease, heart valve problems, arrhythmia, heart failure, previous stroke and heart attack), smoking and blood clots.

How to prevent a TIA and stroke

To reduce your risk of a TIA or stroke, don’t smoke, avoid secondhand smoke, eat a healthy diet, exercise regularly, manage your blood sugar if you have diabetes, cut back on alcohol consumption, and see your primary care provider to have your cholesterol and blood pressure checked at least once a year.

To find a provider near you, visit

Dr. Callahan is a board-certified neurologist at Pardee Neurology Associates.

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