Transient ischemic attack (TIA) is a "micro stroke" in which the blood circulation of the brain is temporarily disturbed. By its signs, TIA resembles a stroke, except that with TIA, symptoms last from a few minutes to one hour. However, this does not detract from the seriousness of TIA, since after it increases the risk of developing a stroke or heart attack. To prevent a stroke after TIA, you should make appropriate changes in your lifestyle and visit a doctor regularly to help you develop a treatment plan.
Diagnosis of transient ischemic attack
The lack of proper therapy and rehabilitation measures for a person who has undergone a transient ischemic attack threatens with a loss of the ability to plan actions, think through some questions to the end, quickly calculate and think abstractly.
Diagnosis of transient ischemic attack and strokes in the Yusupov hospital is carried out using magnetic resonance angiography - the most informative diagnostic method for these conditions, which allows to assess the degree of vascular damage.
The specialized neurology clinic of the Yusupov hospital is equipped with all the necessary equipment and has a powerful arsenal of tools to prevent complications of transient ischemic attack and strokes, as well as to accelerate the rehabilitation time after suffering pathologies.
Neurological rehabilitation after a transient ischemic attack in the Yusupov hospital
The rehabilitation clinic of the Yusupov Hospital is a unique medical institution, the specialists of which direct all their efforts to restore the body functions lost due to the disease in patients. This medical area receives maximum attention from both theoretical and practical medicine. Recovery after a transient ischemic attack involves the use of an integrated approach, which includes various methods of influence, when one event complements and simultaneously strengthens another.
Our rehabilitation doctors include unique rehabilitation programs, innovative medical technologies and techniques in the scheme of rehabilitation measures.
Rehabilitation after a transient ischemic attack in the Yusupov hospital is aimed at emergency recovery, returning patients to their health and performance as soon as possible and without additional damage.
For all rehabilitation measures, a hospital and specialized outpatient clinics are equipped; when choosing a tactic, our specialists use an individual approach for each clinical case.
Exercise after transient ischemic attack and stroke
Therapeutic exercise (LFK) is a mandatory and very powerful recovery tool after a transient ischemic attack. Neurologists at the Yusupov hospital prescribe it in the first days after the attack. Exercise therapy should be performed at all stages of treatment, and ideally - all subsequent life.
By the strength of their positive impact, regular exercise after a transient ischemic attack and stroke can compete even with the most modern medicines. After the reserve of therapeutic agents is exhausted, only exercise therapy can help reduce neurological deficit. The restoration of neurons that died during brain disasters, of course, is not possible, but regular physical exercises increase the activity of other brain neurons and, due to this, provide excellent compensation for lost functions.
Physical exercises after a transient ischemic attack and strokes have the following tasks:
- to prevent complications of prolonged immobilization (pressure sores, congestive pneumonia, progression of congestive heart failure, thromboembolic complications, muscle mass atrophy),
- improve muscle tone and strength in muscles that are in a state of paresis or paralysis with reduced tone,
- muscle pathological tone in muscle groups that are in a state of spastic paresis or paralysis with increased muscle tone,
- improve microcirculation and metabolic processes in all body tissues,
- Prevent muscle contracture
- resume motor activity,
- restore the speech functions of the body,
- normalize the activity of internal organs,
- restore subtle hand movements.
Physiotherapy exercises is effective, but not the only rehabilitation method after a transient ischemic attack and stroke. The highest efficiency is achieved if exercise therapy is combined with massage, manual therapy, treatment, social and psychological adaptation.
Rehabilitation after a transient ischemic attack in the Yusupov hospital is a full-fledged recovery program that allows you to avoid the development of severe consequences of cerebrovascular accident.
To make an appointment with the doctor of a neurology or rehabilitation clinic, you can call the Yusupov hospital or contact our specialists online through the feedback form on the website. You will be provided with complete information about the cost of the services provided, the conditions of hospitalization and other nuances of staying in the clinic.
General information about TIA
A transient attack is a short-term violation of the blood supply to certain parts of the brain tissue, which leads to hypoxia and cell death.
Consider the main difference between transient ischemic attack and stroke:
- The mechanism of development. With stroke lesions, there is a complete cessation of blood flow to the brain tissue, and during transient ischemia, a slight blood flow to the area of the brain remains.
- Duration Symptoms with TIA after several hours (maximum - a day) gradually subside, and if a stroke occurs, then the signs of deterioration remain the same or progress.
- The possibility of spontaneous improvement of well-being. The ischemic attack gradually stops, and healthy structures begin to perform the function of dead brain cells and this is one of the main differences from a stroke, in which, without medical assistance, the foci of necrosis increase, and the patient's condition gradually gets heavier.
It may seem that a transient ischemic attack of the brain is less dangerous than a stroke in the brain tissue, but this is an erroneous opinion. Despite the reversibility of the process, frequent oxygen starvation of brain cells causes irreparable harm.
Causes of the development of short-term ischemia
From the description of the mechanism, it is clear that transient attacks of ischemic origin provoke a partial closure of the vessel and a temporary decrease in cerebral blood flow.
Cholesterol plaques in blood vessels
Provoking factors for the development of the disease are:
- atherosclerotic plaques,
- hypertonic disease,
- cardiac pathologies (coronary heart disease, atrial fibrillation, heart failure, cardiomyopathy),
- systemic diseases affecting the inner vascular wall (vasculitis, granulomatous arthritis, SLE),
- cervical osteochondrosis, accompanied by a change in bone processes4
- chronic intoxication (abuse of alcohol and nicotine),
- advanced age (50 years and older).
In children, pathology is often provoked by congenital features of the cerebral vessels (underdevelopment or the presence of pathological bends).
The presence of one of the causes of transient ischemic attack indicated above is not enough, for the appearance of the disease, the influence of 2 or more factors is necessary. The more provocative causes a person has, the higher the risk of an ischemic attack.
Symptoms are localized.
In a transient ischemic attack, the symptoms may vary slightly depending on the place of development of temporarily developed ischemia. In neurology, the signs of the disease are conditionally divided into 2 groups:
These include cerebral signs:
- migraine-like headache
- coordination disorder
- difficulty orientation
- nausea and non-relieving vomiting.
Despite the fact that similar symptoms occur in other diseases, the symptoms listed above suggest that an ischemic attack of the brain has occurred and a medical examination is necessary.
Neurological status is evaluated in a medical institution by specialists. By the nature of the patient's deviations, the doctor, even before conducting a hardware examination, will be able to suggest an approximate location of the pathological focus. According to the localization of ischemia, there are:
- Vertebrobasilar. This form of the pathological process is noted in 70% of patients. A transient ischemic attack in the vertebrobasilar basin develops spontaneously and is often provoked by a sharp turn of the head to the side. When a focus is found in the WBB, there are general clinical signs and a visual impairment is added to them (it becomes fuzzy), slurred speech, motor and sensory disorders.
- Hemispheric (carotid artery syndrome). The patient will develop migraines such as pain, dizziness, difficulty coordination, and fainting. A provoking factor will almost always be changes in the vertebrae in the cervical region.
- SMA (spinal muscular atrophy). With damage to the carotid pools of the brain in humans, a unilateral decrease in motor activity and sensitivity of one or both limbs is noted, visual impairment in one eye is possible. A distinctive feature of this form of pathology is that with ischemia in the right carotid pool, the right eye suffers, and paresis occurs on the left. If the focus is located in the left pool, the SMA develops on the right.
In some cases, with a mild or moderate ischemic attack of the brain, the symptoms do not have a characteristic severity. Then, before identifying the localization of the pathology using special equipment, they say that an unspecified TIA has occurred.
The acute phase of the pathology is diagnosed on the basis of the patient’s symptoms (local status) and clinical and laboratory examination. This is necessary to exclude diseases that have similar symptoms:
- brain tumors
- meningial lesions (infections or toxic lesions of the meninges),
For differential diagnosis apply:
These types of hardware examinations help identify foci of ischemia and necrosis of brain tissue.
MRI room in the clinic
Additionally, to clarify the etiology of the disease, the patient is prescribed:
- peripheral blood test,
- blood coagulation testing
- lipid samples (cholesterol and triglyceride content),
- urinalysis (provides additional information about metabolic processes).
In addition to laboratory tests, a person is given:
- Dopplerography. The speed of blood flow and the nature of the filling of the vessels are determined. It makes it possible to identify areas of the brain with low blood supply.
- ECG. It allows to detect cardiac pathologies.
- Angiography. The introduction of a contrast medium and a series of x-rays allows you to determine the nature of the distribution of blood flow in the vessels of the brain.
- Eye fundus examination by an ophthalmologist. This check is necessary even if there are no signs of visual impairment. If the carotid pool is affected, then the circulation of the fundus from the affected side always suffers.
With the onset of violations, signs of a transient ischemic attack are easy to detect if you immediately call an ambulance or deliver a person to a medical facility.
A distinctive feature of the transient attack is that the arising violations are transient and a day after the attack, the patient almost does not feel discomfort and can lead a full-fledged lifestyle, but short-term ischemia does not pass without a trace.
If such patients seek medical help and report that yesterday they had signs of visual impairment, sensitivity or physical activity, then the examination is carried out by the same method. This is due to the fact that brain tissue is sensitive to hypoxia and even with short oxygen starvation, cell structures die. Foci of arising necrosis can be identified using hardware research.
In a transient ischemic attack, the diagnosis helps not only to identify affected necrotic lesions, but also to predict the possible course of the disease.
First aid and treatment
At home, it is impossible to provide full assistance to the patient - qualified actions of medical workers are needed.
First aid to the patient before the arrival of doctors will consist of 2 points:
- Call an ambulance or deliver a person to a medical facility.
- Providing maximum peace. The victim of a transient attack is disoriented and scared, so you need to try to calm the patient and lay him down, always with his head and shoulders raised.
Self-medication is not recommended. It is allowed only with elevated pressure to give a tablet of a fast-acting antihypertensive drug (Physiotens, Captopril).
When can I get up after a transient ischemic attack, if the victim could not be delivered to the doctor during the attack? There are no strict restrictions here, but doctors recommend limiting physical activity a day after an attack (the patient should lie down more, and do not make sudden movements when changing postures).
In a transient ischemic attack, the standard of care is as follows:
- Restoration of full blood flow in the cerebral vessels (Vinpocetine, Cavinton).
- Reducing the number of damaged brain cells (Nootropil, Cerebralizin, Piracetam).
- Decreased intoxication caused by a lack of blood circulation (Reopoliglukin infusion).
Further emergency care is provided taking into account the additional symptoms that have arisen:
- Signs of thrombosis or blood clotting. Cardiomagnyl, Aspirin or Thrombo ACC are used.
- The development of vascular spasm. Use nicotinic acid, papaverine or nicoverin.
With elevated cholesterol levels, statins are prescribed to prevent the formation of atherosclerotic plaques.
Patients in the acute phase are subject to hospitalization in a hospital, where the necessary treatment will be performed during a transient ischemic attack.
If a person went to a medical institution some time after the attack, then therapy is allowed on an outpatient basis.
Most patients are interested in the duration of treatment, but only the attending doctor can answer this question, but it is important to tune in to a long course of therapy and strictly follow clinical recommendations.
Despite the fact that specific rehabilitation in this condition is not needed, it should be remembered that during the attack a small number of neurons died and the brain becomes vulnerable to the development of serious complications.
In a transient ischemic attack, the prophylaxis is the same as for other conditions associated with vascular disorders:
- Elimination of risk factors. Bringing blood parameters to normal (cholesterol, coagulability).
- Increased physical activity. Moderate physical activity normalizes blood circulation throughout the body, increases immunity and reduces the risk of TIA. But when playing sports it is necessary to observe moderation. If a person has already developed transient ischemia or is at risk for the development of pathology, then swimming, yoga, walking or medical gymnastics should be preferred.
- Diet. With high blood coagulation, hypercholesterolemia or diabetes, nutritionists select a special nutrition program. General recommendations for the preparation of the menu include: the restriction of "harmful goodies" (smoked, fatty, pickles, canned and semi-finished products), as well as the addition of vegetables, fruits and cereals to the diet.
- Timely treatment of exacerbations of chronic pathologies. Above was a list of diseases that provoke ischemic attacks. If you do not start them and treat the complications arising in a timely manner, but the likelihood of a pathology is greatly reduced.
Knowing what TIA is, do not neglect preventive advice. Medical recommendations that are not difficult to follow will help to avoid serious consequences.
Prediction of Ischemic Attacks
After a single transient ischemic attack, the consequences are invisible and the clinic disappears after a day, but the further prognosis is not always favorable - the tendency to re-develop TIA increases, and, with the influence of additional adverse factors, the following complications may appear:
- Transient ischemic stroke. The impaired blood flow does not recover after an hour and irreversible death of cell structures occurs.
- Hemorrhagic stroke. With wall weakness, a partially blocked vessel cannot withstand high blood pressure below the site of blood flow disturbance and rupture occurs.The spilled blood infiltrates brain structures, impeding the functioning of cells.
- Visual impairment. If the focus is localized in the vertebrobasilar system, then a violation of the visual fields or a strong decrease in severity is possible. When the violation is located in the pool of the right artery, the SMA will be left-sided, but it is likely that the visual function on the right and vice versa will suffer (vision in one eye will remain).
The forecast is aggravated by the bad habits of the patient, the presence of concomitant diseases and risk factors, as well as old age.
Who to contact
When the first signs of a transient ischemic attack are detected, an ambulance must be called. The arrived medical team will provide the necessary assistance to the patient and deliver the person to the right specialist.
If transportation is carried out independently, then the patient must be shown to a neurologist.
Having studied the necessary information about the TIA diagnosis - what is it and what is dangerous, it becomes clear that this condition cannot be ignored. Despite the fact that the arising disorders are reversible and do not affect a person’s lifestyle, they cause the death of part of the brain structures and, under adverse circumstances, cause disability.