Transient ischaemic attack (TIA)

A transient ischaemic attack (TIA or mini-stroke) is the same as a stroke, but the symptoms last a short time. You get stroke symptoms because a clot is blocking the blood supply in your brain. When the clot moves away, the stroke symptoms stop.

You might feel like you're fine afterwards, but it's vital to get medical help right away.

Having a TIA is a warning that you are at risk of having a stroke. The risk is greatest in the first days and weeks after a TIA. So you urgently need to find out what caused it, and get advice and treatment to help you stay healthy.

The information on this page can be accessed in the following formats:

Download this information as a pdf or large print Word document.
Order a printed copy from our shop.
To request a braille copy, email helpline@stroke.org.uk.

TIA symptoms

A TIA has the same main symptoms as a stroke. Use the FAST test to check your symptoms.

A TIA is a medical emergency, the same as a stroke. If you spot the signs of a TIA or stroke, call 999. Don't wait to see if the symptoms pass.

If you didn't get medical help within 24 hours, get an urgent appointment with your GP or go to an NHS urgent treatment centre. You need to get your symptoms checked as soon as possible.

Why does it happen?

Clots in the brain can happen in different ways, and doctors look for risk factors like high blood pressure, heart problems or smoking. They'll talk to you about your health and give you the treatment and advice you need. Read more about risk factors for TIA.

Will I have a stroke?

It's difficult to tell for sure if someone is going to have a stroke after a TIA. But having a TIA is a major sign that you have a much higher than normal risk of having a stroke. That's why doctors work so hard to find out what caused it, and help you improve your health. And by following treatments and making healthy lifestyle changes, you can actively reduce your risk of a stroke.

Your risk of a stroke goes down over time following a TIA. So by looking after your health, you can give yourself the best possible chance of staying well in the long term.

Do not drive after a TIA

After a TIA, by law, you must not drive for a month. Read more about driving and stroke or call our Helpline for more information.

What happens next?

If you call 999 with stroke symptoms, you should be taken to the hospital. If you go to your GP after TIA symptoms, they can refer you to hospital for an assessment. If a TIA is suspected, you will be given aspirin to reduce the risk of a stroke.

Diagnosing a TIA

A GP or paramedic will ask you about what happened. If they think you may have had a TIA, they will arrange for you to see a specialist doctor or nurse within 24 hours of your symptoms.

Your appointment with a specialist might be at a TIA clinic, or in a hospital stroke unit. If a TIA is confirmed, doctors will try to find out how it happened. You will be given treatment and advice to reduce your risk of having a stroke in future.

What happens at your appointment

The most important information for confirming a TIA is your story about the symptoms and when they happened. Symptoms can be caused by other problems, so the specialist doctor or nurse will listen carefully to you and confirm if you've had a TIA. You may have a brain scan, but not everyone needs a scan.

You'll have tests for health problems linked to stroke, such as high blood pressure, high cholesterol and diabetes. You might have heart monitoring to check for heart conditions. You might have an ultrasound scan to check for blocked blood vessels in your neck.

Why didn't I have a brain scan?

A TIA is a temporary clot in your brain, so it doesn't always cause damage that would show up on a scan. If doctors are not sure what caused your symptoms, you may have a magnetic resonance imaging scan (MRI). This can rule out other causes of the symptoms, such as bleeds or abnormalities in the brain. An MRI can sometimes show the site of the TIA, especially if it's done soon after it happens. But this is not the main way that a TIA is diagnosed.

How does a TIA happen?

Clots that cause a TIA can happen for different reasons. One type of clot is caused by a build-up of fatty deposits in the blood vessels around your body, known as atherosclerosis. Another type of clot is due to heart conditions such as atrial fibrillation (a type of irregular heartbeat). This can lead to a clot forming in the heart and travelling to the brain.

Damage to the arteries in the neck, known as arterial dissection, can also cause clots. Small vessel disease is a condition where the tiny blood vessels deep inside your brain get blocked. This can also lead to clots forming and causing a TIA or stroke.

Treatments to reduce the risk of another clot

Having a TIA means that you had a temporary clot in your brain, giving you stroke symptoms. TIA treatments aim to reduce the chance of another clot entering your brain.

Blood-thinning medication

You will be offered a type of blood-thinning medication to reduce the risk of another clot. If your clot was due to high blood pressure, or clogged arteries due to fatty deposits (atherosclerosis), you will be given anti-platelet medication. This makes the sticky particles in your blood less likely to clump together and form clots.

If the clot came from the heart because of a condition like atrial fibrillation, you may be given an anticoagulant. This slows down the formation of clots in your blood.

Treating blocked arteries in the neck

If you have a blocked artery in your neck (carotid artery) you might be offered surgery to clear the blockage.

Treating arterial dissection

If you have a damaged artery in the neck, known as an arterial dissection, you will be given blood-thinning medication to take while the artery heals. Arterial dissection is often due to an injury, and it's more common in younger adults and children.

Risk factors for TIA and stroke

The risk factors for TIA are the same as for ischaemic stroke. Things that can make you more likely to have a stroke include your age, lifestyle, ethnicity, and family history of stroke.

When you are diagnosed with TIA, you'll be given advice about your individual risk factors. You'll be offered support with lifestyle changes such as quitting smoking and being more active.

You can read our information about understanding your risk of stroke and reducing your risk of stroke. We also have information about getting active which includes guidance for people with stroke risk factors and health conditions.

Health conditions linked to TIA and stroke

At your TIA appointment, you'll be tested for health conditions linked to stroke. Some people only find out that they have one of these conditions after a TIA or stroke. You may need to take long-term medication.

High blood pressure

High blood pressure is the biggest single risk factor for TIA and stroke, and it plays a part in half of all strokes. Read more about high blood pressure diagnosis and treatment.

Atrial fibrillation (AF)

Atrial fibrillation (AF) is a heart condition that causes an irregular or abnormally fast heartbeat. It can lead to a clot forming in the heart and travel to the brain, causing a stroke. Read more about AF diagnosis and treatment.

Diabetes

Diabetes causes high levels of sugar in your blood. Over time this damages the blood vessels, which can lead to clots forming and causing a stroke. Read more about diabetes diagnosis and treatment.

High cholesterol

Cholesterol is a vital substance in our bodies, but if there is too much cholesterol in your blood it can clog up the arteries with fatty deposits, leading to a clot forming. Read more about high cholesterol diagnosis and treatment.

Health and wellbeing after TIA

If you've been diagnosed with a health condition following a TIA, such as high blood pressure or atrial fibrillation, you will be offered medication and advice about reducing your risk of a stroke.

Managing long-term medications

After a TIA, you might need to start taking one or more types of long-term medication. Taking your medication is a really important way to cut your risk of a stroke. But it can take a while to get used to some types of drug, and you might need to try different versions to find one that suits you.

If you have any problems like side effects or forgetting to take your medication, have a chat with your pharmacist. And don't stop any medications before speaking to a GP. Some medicines can cause side effects if you stop suddenly, and stopping a drug will increase your risk of a stroke.

Seek support for yourself

The changes in your life after a TIA might feel like a lot to deal with. For example, you might need to take several types of drugs such as statins, blood-thinners and high blood pressure medications. These treatments are usually long-term. On top of that, you might be trying to make lifestyle changes such as giving up smoking or losing weight. This can be a practical challenge, and it could have an emotional impact.

So, if you are struggling with things like managing your treatment and changing your diet, try to seek support for yourself.

This could mean sharing your feelings with family and friends. They might be able to help by joining in with your plans for healthy lifestyle changes, or give practical support with taking medication.
Your pharmacist and GP can support you with advice or a medications review.
Join our Online Community and connect with thousands of people on the forum who understand stroke first hand. Chatting to people can help you cope better and rebuild your life after stroke.

Be as active as you can

Moving more and being as active as you can is one of the best ways to reduce your risk of a stroke. Being active can also help you sleep better, and avoid low mood. It can help to reduce the effects of health conditions like high blood pressure, diabetes and high cholesterol.

For practical tips and ideas about being active, visit our tailor-made online information about getting active after a stroke.

Eat a healthy diet

A healthy diet with plenty of fruit and vegetables can lower your risk of stroke by helping you manage health problems linked to strokes, like diabetes and high cholesterol. You don't have to change your diet all at once – try adding a piece of fruit or vegetable each day, like a banana or tomato with lunch. Read more information about healthy eating.

Aim for a healthy body weight

TIA and stroke can happen to people of any body size and shape. But having more body fat raises your risk, and reducing your weight if you need to can make you less likely to have a stroke.

Losing weight can reduce high blood pressure and improve diabetes. It can also lower your cholesterol. You may even be able to reduce or stop taking certain medications. So if you lose weight, go back to your GP to discuss your health and medication.

Having a good diet and being active can help you stay a healthy weight. But many people find it's helpful to have some support such as a club or using a weight-loss app. Speak to your GP or pharmacist about help available locally.

Quit smoking

If you're a smoker, quitting smoking is likely to be the first piece of advice you get after a TIA. Read our information and advice about stopping smoking and how to get help to quit.

Avoid drinking large amounts of alcohol

Regularly drinking too much alcohol raises your risk of a stroke. It raises your blood pressure, especially if you drink a lot in one go. There are resources online at drinkaware's website and your GP can advise you about help available locally. Read more about alcohol and stroke.

Professor Peter Rothwell talks about TIA

TIA: things people tell us

"I feel fine now. I'm too busy to attend my TIA appointment."

Even if you feel OK, a TIA is a major warning sign of a stroke. Attending a TIA clinic and follow-up appointments can tell you what caused the TIA. You'll get treatment and advice to help you reduce your risk of a stroke, and stay fit and well. So try to give your appointments top priority.

"I'm worried about what I might find out at the TIA appointment."

It can be very worrying to be told that you had a TIA. But by attending medical appointments and following any treatment and advice, you have a chance to make a real difference to your future health.

"I don't like to bother anyone."

Medical professionals are trained to investigate symptoms of a stroke. They can reassure you, or give medical help if you need it.

"Why am I taking medication? It isn't doing anything."

After a TIA you're likely to be given at least one type of long-term medication, and possibly two or more.

Most of the conditions linked to strokes such as having clogged arteries or high blood pressure don't have any symptoms, or very few. So when you start taking medication, it probably won't have a noticeable effect on how you feel physically. But taking these medications could significantly cut your chance of a stroke.

If you're struggling with taking any of your medicines due to side effects or practical difficulties, speak to your pharmacist or GP. Don't stop taking a medicine without speaking to your GP, as this could raise your risk of a stroke.

TIA of unknown cause

Sometimes, doctors can't find out exactly what caused a TIA or stroke. You will be checked for the main risk factors for stroke such as high blood pressure, diabetes, blocked arteries and atrial fibrillation (a type of irregular heartbeat).

Treating a TIA of unknown cause

Even if the cause isn't found, you will probably be given the same treatment used for any TIA, which is usually blood-thinning medication to avoid another clot. If you have high blood pressure, diabetes or high cholesterol you will be offered treatment for those conditions too.

Stay healthy and reduce your risk

Like anyone with a TIA, you can help to improve your health by sticking to your medications as well as having a healthy diet and being active.

If you're already fit and active, try to keep going – it will not only make a stroke less likely, but it will also help you stay healthy and improve your mood. If you need to make some lifestyle changes like quitting smoking or losing weight, ask your GP or pharmacist about the help that's available in your local area.

If you have questions about your TIA or just want to speak to someone, call our Helpline on 0303 3033 100.

Long-term effects of TIA

Fatigue

Although the physical signs of a TIA end quickly, it can have some long-term effects. Some people get fatigue (extreme tiredness which doesn't always get better with rest). This could affect you going back to work after a TIA, or limit how much you can do around the house.

You might need to discuss things with your employer and family. Make them aware of how you are feeling, and any support you might need. Read more information and practical tips about fatigue.

Emotional impact

A TIA can have an emotional impact. You could feel very shocked, and you might feel worried about your health. Some people have problems with anxiety and low mood. Sharing your feelings with family and friends can help them understand what you are going through. Talking about your feelings can also help reduce anxiety and help you deal with what you are going through.

Staying active or doing some exercise can help to improve your mood. Regular activity can also help with fatigue by helping you sleep better and improving energy levels. Read more about the emotional effects of stroke and TIA.

Focus on your wellbeing

By following any treatment and making some healthy lifestyle changes you'll be helping your general health and wellbeing. Doing things like quitting smoking, eating healthy food and moving more make you feel better in yourself. You'll also know that you are doing all you can to improve your health and reduce your risk of a stroke.

If you feel that anxiety or low mood is affecting your daily life, contact your GP, or call our Helpline for ideas on finding support.

What to do about other problems

If you still have physical or cognitive problems (difficulties with memory and thinking) after a TIA, raise this at a clinic appointment or with your GP, as you might need some further investigations.