Since a TIA doesn't last very long, there's not much to do to treat its symptoms. They may be mostly gone by the time the ambulance arrives. The focus is on how to prevent another TIA or a full-blown stroke. And there are a lot of steps you can take.
The first line of defense is typically medicine that helps prevent clots from forming. In some cases, you may also need surgery. From there, it's all about making changes for a healthier lifestyle.
Medications That Help Prevent TIAs
Which medicine you might need depends on where the clot occurred, how serious it was, and what caused it.
Antiplatelets. Platelets are a type of blood cell. When you get a cut, platelets cluster around the injury and stick together to form a clot, which stops the bleeding. They play a key role in the healing process.
With a TIA or stroke though, you get a clot that forms when it shouldn't, and that's a problem. Antiplatelet drugs prevent platelets from sticking together. That lowers your chances of having a clot that can block blood flow to the brain.
The most common antiplatelet is aspirin. Doctors often suggest it because it works, it's cheap, and it doesn't have many side effects.
Often, a TIA will be treated with the antiplatelet drug clopidogrel (Plavix), either alone or in combination with aspirin.
If you take antiplatelets, be careful if you get cut because you may bleed more than usual.
Another common side effect is indigestion. You might get problems like heartburn, bloating, or an upset stomach.
Anticoagulants. After your TIA, if you have atrial fibrillation (AFib) -- a problem with your heart's rhythm -- it could be because the clot that triggered your TIA started in your heart. In that case, your doctor is more likely to recommend you take an anticoagulant.
Your body has certain proteins that combine with platelets to make blood clots. Anticoagulants change those proteins to make it harder for them to form clots.
If you only need an anticoagulant for the short term, you might get one called heparin , an injectable. For longer-term use, you might get one of these oral drugs:
- Apixaban (Eliquis)
- Dabigatran (Pradaxa)
- Edoxaban (Lixiana, Savaysa)
- Rivaroxaban (Xarelto)
- Warfarin (Coumadin, Jantoven)
Like antiplatelets, these meds can increase your risk of bleeding. Depending on which drug you take, you may need regular tests to make sure you get just the right dose to prevent a stroke and limit side effects.
Medicines for other conditions. When your doctor runs tests after a TIA, you might learn that you have another health problem that raises your stroke risk. If so, you may get drugs to help manage those conditions. For example, you might get antihypertensives to manage high blood pressure or drugs called statins to treat high cholesterol.
Surgery
If one of the carotid arteries in your neck is narrowed or blocked, you may need surgery to help clear it out and restore normal blood flow. One option is an operation called carotid endarterectomy, where your doctor opens up the carotid artery, scrapes out the plaque, and closes it back up.
Another choice is a procedure called carotid angioplasty and stenting. Your doctor makes a small opening in your groin. They'll use a balloon-like device to widen your carotid artery, then put in a small wire tube, called a stent, to keep it open. They then remove the balloon. This is much less invasive, so it's less risky.
Lifestyle Changes
You may need to make a few tweaks to the way you live your life:
Eat healthy food. Choose whole foods, meaning foods that are as natural and unprocessed as possible. Also eat a low-fat, low-salt, high-fiber diet that has plenty of fruits and veggies. Make sure to limit saturated fats and sugar and avoid trans fats.
Get a good night's sleep. Regular shut-eye can lower your risk of a stroke. Create a routine to relax at night and get to bed at a reasonable time.
Limit alcohol. If you drink, keep it to one drink a day if you're a woman or two if you're a man.
Manage your other health conditions. The more you control issues like high blood pressure, diabetes, and atrial fibrillation, the better.
Stick to an exercise routine. Typically, you need at least 150 minutes of medium-level cardio, like brisk walking, each week. Check with your doctor to see what's safe for you.
Stay at a healthy weight. This will help your blood pressure and cholesterol, too.
Stop smoking.Tobacco harms your health in several ways, including raising your stroke risk.
Avoid illegal drugs. Drugs like amphetamines, cocaine, and heroin can raise your chances of a TIA or stroke.
TIA Risks for Women
In addition to other lifestyle changes, if you're a woman, you should take a few more steps to avoid a TIA or stroke.
For instance, if you're over age 75, ask your doctor to check you for atrial fibrillation.
If you're pregnant, make sure to have your blood pressure checked regularly during and after pregnancy.
If you think you might start birth control pills, get checked for high blood pressure first.
Finally, if you get migraines with auras, it's even more important that you stop smoking right away.