Transient Ischaemic Attacks (TIAs): The “Warning Stroke” You Should Never Ignore

A Transient Ischaemic Attack, often called a TIA or a “mini-stroke”, can be frightening — but it can also be a powerful opportunity.

A TIA is your body’s way of saying:

“Something isn’t right — please pay attention now.”

Understanding what a TIA is, how it differs from a stroke, and what to do next can make a life-changing difference.

What Is a TIA?

A TIA happens when the blood supply to part of the brain is temporarily interrupted.

• Symptoms are stroke-like

• But they fully resolve, usually within minutes to hours

• By definition, symptoms last less than 24 hours (most resolve within 1 hour)

Although the symptoms pass, a TIA is not harmless. It’s a serious warning sign that the brain has been briefly starved of oxygen.

How Is a TIA Different From a Stroke?

TIA	Stroke
Temporary blockage	Blockage or bleed that persists
Symptoms resolve	Symptoms last and may worsen
No permanent brain injury seen on imaging	Permanent brain injury
Strong warning sign	Medical emergency with lasting effects

The key message is this:

A TIA is a medical emergency — even if you feel “back to normal”.

Research shows that the risk of a full stroke is highest in the days and weeks after a TIA, particularly in the first 48 hours.

Common Signs and Symptoms of a TIA

TIA symptoms are the same as stroke symptoms — they just don’t last as long.

Symptoms may include:

• Sudden weakness or numbness (often on one side of the body)

• Slurred or confused speech

• Difficulty finding words

• Sudden vision problems in one or both eyes

• Loss of balance, coordination, or dizziness

• Sudden confusion

Even if these symptoms pass quickly, they must be taken seriously.

Remember FAST (or FACE) — and Act FAST

The FAST test helps recognise stroke and TIA symptoms quickly:

F / FACE

• One side of the face drooping?

• Uneven smile?

A / ARMS

• Can both arms be raised and kept there?

• Is one arm weak or numb?

S / SPEECH

• Slurred speech?

• Difficulty finding words?

• Not making sense?

T / TIME

• Call emergency services immediately

⏱ Do not wait to see if symptoms pass.⏱ Do not drive yourself.⏱ Early treatment saves lives and brain tissue.

How Is a TIA Diagnosed?

There’s no single “TIA test”. Diagnosis is based on:

• A detailed history of symptoms (even if they’ve resolved)

• Neurological examination

• Brain imaging (CT or MRI)

• Heart tests (ECG, sometimes heart monitoring)

• Blood tests

• Carotid artery imaging in some cases

Because symptoms may have disappeared, your description is incredibly important.

Writing down:

• What happened

• How long it lasted

• What improved and when

…can be very helpful.

Why Early Assessment Matters So Much

After a TIA:

• About 1 in 5 people will have a stroke within 90 days if untreated

• Half of those strokes occur within the first 48 hours

The good news?Prompt assessment and treatment can reduce stroke risk by up to 80%.

This is one of the most preventable neurological emergencies we see.

Treatment After a TIA

Treatment focuses on preventing a future stroke, not just explaining the episode.

This may include:

• Blood-thinning medication (e.g. antiplatelets or anticoagulants)

• Blood pressure management

• Cholesterol-lowering medication

• Diabetes management if relevant

• Lifestyle support (movement, smoking cessation, diet)

• In some cases, surgery or procedures for narrowed arteries

Recovery, Neuroplasticity, and Moving Forward

One reassuring aspect of a TIA is that it does not usually cause permanent brain damage.

The brain has an incredible ability to adapt — a property called neuroplasticity.

This means:

• Neural pathways can strengthen

• Efficiency can improve

• Confidence and function often return fully

Some people experience temporary fatigue, anxiety, or reduced confidence after a TIA — this is common and understandable. Support, reassurance, and gradual return to activity are key.

What Can You Do After a TIA?

🧠 Protect Your Brain

• Take medications exactly as prescribed

• Attend follow-up appointments

• Ask questions — understanding reduces fear

🚶 Move Your Body

• Gentle walking is encouraged early

• Progress gradually

• Exercise improves blood flow, mood, and brain health

🧘 Look After Your Wellbeing

• Anxiety after a TIA is common

• Poor sleep and fatigue are normal initially

• Talking about fears helps recovery

❤️ Address Risk Factors

• Stop smoking

• Manage blood pressure

• Stay active

• Eat a heart-healthy diet

Small changes make a big difference over time.

A Positive Final Message

A TIA is serious — but it is also a second chance.

It offers a window to:

• Understand what your body is telling you

• Reduce future stroke risk

• Take positive steps toward long-term brain and heart health

With early treatment, good medical care, and a gradual return to activity, most people recover well and go on to live full, active lives.

If you or someone you care for has had TIA symptoms — even if they passed quickly — don’t ignore them. Acting early can be life-saving.

Selected Evidence & Further Reading

• Easton, J.D. et al. (2009) Definition and evaluation of transient ischemic attack, Stroke.

• Giles, M.F. & Rothwell, P.M. (2007) Risk of stroke early after transient ischaemic attack, Lancet.

• Johnston, S.C. et al. (2000) Short-term prognosis after emergency department diagnosis of TIA, JAMA.

• NHS England (2023) Transient ischaemic attack (TIA).

• Wardlaw, J.M. et al. (2014) Neuroimaging in TIA and stroke, Lancet Neurology.