Difference between stroke and transient ischemic attack

Differences Between a Stroke and a TIA

There are enough vague terms in medicine, as in any science. In today’s article, we will learn what a stroke is and what a TIA is, and we will understand how do TIA and a stroke differ. Also, we want to share with you the symptoms of both types. The main difference between TIA and stroke is thought to be determined by diffusion-weighted magnetic resonance imaging. Nevertheless, not all researchers share this approach to the diagnosis of TIA, and a stroke, and often final, diagnosis of this syndrome remains clinical. 

Stroke (when it comes to comparing TIA, we mean the ischemic type) is a consequence of acute dysfunction of blood circulation in the brain, characterized by irreversible changes in its tissues. Unlike a stroke, with a TIA, the clot dissolves on its own, and symptoms go away. Patients who have undergone TIA have a 9-fold increased risk of stroke. 

Why is TIA not a stroke?

Both transient ischemic attack and ischemic stroke are states of the ACVA group (which, when deciphered, sounds like an acute cerebrovascular accident). 

Even the reasons for their development are the same:

• atherosclerosis
• arterial hypertension
• heart defects
• dysfunction of the blood coagulation system
• vascular complications of diabetes mellitus
• vascular lesions in systemic connective tissue diseases (for example, in the case of periarteritis nodosa)

The difference lies in the severity of the condition and its reversibility. Ischemic stroke (also called cerebral infarction) is a condition in which cells in the affected area of the brain die off and necrosis occurs. This causes various consequences, from speech impairments to loss of body mobility, which are always persistent, associated with the loss of the functions of active brain zones. TIA lasts from 10-15 minutes to several hours, but less than a day; after the blood flow in the vessels increases, the neurological symptoms quickly disappear. At the same time, there is a so-called “minor stroke” in the ACVA classification. We are talking about a violation of cerebral circulation with moderately pronounced neurological symptoms, recovery after which takes a relatively short time – from 2 days to 3 weeks. It cannot be considered a prolonged version of TIA since cell necrosis does occur.

TIA vs. stroke: are there any differences?

The main difference is in the severity of manifestations. Symptoms of a transient ischemic attack develop suddenly, can be quite bright but often disappear even before a doctor examines the patient. A stroke can develop acutely or have “precursors” – all the same, repetitive TIA, sudden changes in blood pressure, etc. The clinical picture of stroke is very similar to a transient ischemic attack. In fact, this is a more severe variant of blood flow dysfunction, when the vessel’s permeability is not restored and stops for so long that the cells of the brain area die due to hypoxia (oxygen starvation). 

The clinical picture of stroke consists of two syndromes: 

1. Cerebral:

• strong headache
• dizziness, unsteadiness when walking
• nausea, vomiting
• sometimes – convulsions, fainting
• drowsiness or, conversely, agitation
• feeling overwhelmed
• pain in the eyeballs when moving
• the feeling of increased temperature, dry mouth
• excessive sweating 

• Focal neurological:

• sensitivity disorders;
• disorders of speech, vision, hearing, in especially severe cases – also breathing, heart rhythm;
• memory impairment, information perception;
• mental disorders (emotional disinhibition, hallucinations);
• impaired consciousness to coma;

The symptomatology of a stroke is growing rapidly and does not disappear spontaneously. The patient needs urgent help and treatment in the intensive care unit. 

TIA vs. stroke, which is more dangerous?

After reading the previous sections of the article, the answer to this question should be obvious. Stroke is a serious irreversible disease that cannot end independently without obvious consequences, unlike TIA.

Several decades ago, even doctors neglected this, but today the attitude towards TIA is completely different. Why? There are several reasons: 

1. Patients who often suffer ischemic attacks have a high risk of developing severe ischemic stroke.
2. Knowing that the symptoms will pass, patients do not go to the doctor – and in the meantime, their condition is aggravated because the diseases that caused the attack are progressing.
3. TIA requires competent treatment (in a hospital, then on an outpatient basis) and constant monitoring of the blood pressure level.

Therefore, although the prognosis for a patient with a stroke is certainly worse, any TIA types are a reason for immediate medical attention and emergency hospitalization. Patients with transient ischemic attacks should know how to threaten this condition, and together with a doctor, take measures to prevent the development of stroke. The fundamental difference between TIA vs stroke is that in the first case, as the name suggests, cerebral dysfunctions are transient, reversible. TIA is a formidable prognostic sign or harbinger that requires mandatory intervention and correction of etiopathogenetic factors.