Transient ischemic attack: what is it?
Acute attacks of focal and common cerebral disorders that develop on the background of disturbed cerebral circulation and do not last more than 24 hours are called transient ischemic attacks (TIA). This article explains what it is, also lists the etiology, clinical manifestations and treatment of such pathological conditions.
As a rule, a temporary blockade of blood supply of separate areas of the brain occurs due to blockage of small blood vessels accumulation of platelets or particles of atherosclerotic plaques. Other common causes:
- embolism on the background of various pathologies of the heart (e.g., arrhythmias, valvular lesions of the heart, heart attack, blockades, endocarditis and heart failure);
- sudden arterial hypotension;
- osteochondrosis of the spine in the neck, which is accompanied by compression and spasm of blood vessels;
- blood loss;
- aplasia of the cerebral vessels or kinking;
- severe hypoxemia (e.g. in severe anaemia).
Provoking factors is physical inactivity, hypercholesterolemia and obesity, hypertension and diabetes, Smoking and taking large doses of alcohol.
The symptoms depend on the localization of the pathological area, in which disrupted blood flow. The syndrome of vertebrobasilar system following complaints:
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- severe dizziness;
- hiccups and vomiting;
- excessive sweating;
- expressed headaches;
- changes of movement coordination;
- visual disturbances in the form of photopsias (flashing lights), double vision or loss of sight;
- changes in blood pressure;
- impairment of memory and sometimes of speech.
With the development of the syndrome of the carotid artery may disappear vision 1 eye, you experience numbness in the extremities, the weakening of the movements of the lower facial area, short convulsions of the limbs (there opposite from the side of ischemia), as well as unexpressed changes of speech.
In the presence of pathological changes in the area of cerebral arteries is disturbed sensitivity and motor activity of the opposite of ischemia, temporarily disturbed by it, there are convulsions and loss of vision on the same side as the affected vessel in the brain. In the pathology of the vertebral arteries was observed bouts of muscle weakness. The consciousness patient is not disturbed, convulsions are absent.
Typically, symptoms of TIA appear suddenly. Often precipitating factor is emotional stress or excessive physical work. It is important to note that 24 hours after the onset of complaints, all the signs of ischemia should disappear. Transient ischemic attack is not life-threatening, but indicates the possibility of bleeding in the brain which may give severe consequences (for example, leads to disability or even death completed).
Features of treatment
Before prescribing appropriate therapy necessarily spend differential diagnostics. Similar neurological signs were observed in migraine with aura, epilepsy, early stages of multiple sclerosis, and Meniere’s disease. To diagnose recommend patients to take blood tests and ECG, as well as to dopplersonography and duplex scanning of cerebral arteries. In some cases, shown transthoracic echocardiography, MRI and Mr angiography. When the complaints which can indicate a transient ischemic attack, you should immediately call a doctor. Emergency assistance is as follows:
- the patient should be put on a flat hard surface, prohibit to move, head slightly raised to prevent swelling of the brain tissue;
- if vomiting occurs, the head should turn sideways, otherwise, vomit may enter the respiratory tract and cause asphyxia;
- on the forehead put a cold bandage to calm the patient;
- to free the body from pressure of clothing;
- to measure pressure, as when a sharp rise in the need to take anti-hypertensive medication (according to doctor’s recommendation);
- if signs of clinical death, which to start resuscitation.
Treatment after hospitalization is directed to recovery of blood flow and protect brain tissue from the compounds which are formed as a result of impaired circulation. The main goal of therapy is preventing the progression of ischemia, which can lead to stroke.
Among the pharmacological agents used in the treatment of TIA should be allocated to ACE inhibitors, Nifedipine, Kordafen or another calcium antagonist, sodium nitroprusside, Nitroglycerin and beta-blockers and regidratanty.
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Shows the reception of thrombolytics, anticoagulants and antiplatelet agents, vasoactive drugs with antiaggregatory effect. To improve cerebral circulation appoint vasoactive medications (e.g., Trental, Cavinton, Cinnarizine). To improve metabolism in the brain tissue used neuroprotectors and antioxidants (Actovegin, Cerebrolysin, Piracetam, Tanakan). To stabilize the operation of the neurons use Gliatilin containing choline.
Necessarily symptomatic therapy. If transient ischemic attack of the brain is accompanied by severe vertigo, used benzodiazepines. To eliminate nausea and vomiting prescribed Torecan or Metoclopramide. To eliminate headaches prescribed nonsteroidal anti-inflammatory drugs and analgesics of the non-opioid group. If concomitant hypertension is taking Furosemide and Mannitol.
After the elimination of acute manifestations may be conducted hyperbaric oxygenation, electrophoresis, microwave therapy, darsonvalization, massage, salt and pine baths. It is advisable to carry out therapy in the first hours after the onset of symptoms of TIA. This allows you to quickly restore blood circulation and prevent the appearance of necrotic changes in brain tissue which are irreversible.