Transient Ischemic Attack

Transient ischemic attacks (TIAs) are temporary deficits in neurologic function caused by a brief interruption of blood flow to part of the brain. Although the symptoms — such as weakness or numbness on one side of the body and difficulty speaking — are short-lived, TIAs are also possible warning signs of a full-blown stroke. Research conducted at Boston Children’s Hospital indicates that about 10 percent of children who experience a TIA will ultimately have a stroke.

Transient ischemic attacks (TIAs) produce sudden symptoms similar to those of strokes, such as:

• Weakness or numbness on one side of the body
• Difficulty speaking or understanding speech
• Vision problems
• Confusion
• Sensation that the room is spinning (vertigo)

Symptoms of TIAs last less than 24 hours — often only for a few minutes and resolve. Children can experience multiple TIAs, which can be warning signs that a full-blown stroke may occur.

TIAs occur when blood flow to a portion or region of the brain is interrupted, typically by a blood clot. Certain conditions are associated with an increased risk of having a TIA, including:

• Cerebral arteriopathies, such as moyamoya disease
• Sickle cell disease
• Congenital heart disease (CHD)
• Migraines
• Inflammatory conditions
• A history of stroke

Your child’s physician may use a number of procedures to diagnose a transient ischemic attack (TIA):

• Imaging of the brain and blood vessels in the head and neck using MRI (magnetic resonance imaging), CT (computed tomography) and catheter angiography protocols designed here at Boston Children’s
• A cardiology evaluation to look at the heart for cardiac conditions that could lead to TIA
• Blood tests, including a panel of tests associated with bleeding or clotting disorders (thrombophilia testing), inflammatory disorders or metabolic disorders
• Genetic studies to look for hereditary risk factors for blood clots
• A transcranial ultrasound assessment to assess blood flow in the brain

Depending on the underlying cause of the TIA, your child’s care team may recommend treatments to help prevent a full-blown stroke from occurring. For example, some causes of TIAs, such as malformations of the blood vessels in the brain, can be treated at the Cerebrovascular Surgery and Interventions Center, using surgical or catheter-based techniques. However, the team at the Stroke and Cerebrovascular Center can use medical therapies for other causes of TIA.

The diverse team of specialists in the Stroke and Cerebrovascular Center at Boston Children’s Hospital provides fast, comprehensive evaluations to quickly identify if and why a TIA has occurred.

Our team approach means that your child will benefit from the combined expertise of child neurologists, pediatric neurosurgeons, hematologists, neurointerventional radiologists, pediatric neuroradiologists, emergency medicine physicians, child psychiatrists, physical and occupational therapists, and speech and language therapists. We also offer long-term multidisciplinary care to help prevent future strokes.