6 Early Warning Signs of a Ministroke (TIA)

Key takeaways:

Ministrokes (transient ischemic attacks) are caused by blocked blood flow to a specific area of the brain.
Early warning signs of a ministroke include one-sided weakness, speech problems, vision loss, and balance problems.
Seek medical care immediately if you’re experiencing symptoms of a ministroke.

Ministrokes are brief episodes of low blood flow to the brain that resolve on their own. They’re also called transient ischemic attacks (TIAs). TIAs resolve on their own within 5 to 10 minutes. But they can also last as long as 24 hours.

Ministrokes don’t cause lasting damage to the brain. But they’re an important warning that you’re at high risk of developing a stroke in the near future.

The symptoms of a stroke and ministroke are often the same. So it’s important to get care right away if you’re experiencing ministroke symptoms. That’s because you could actually be having a stroke. Here are six early warning signs of a ministroke you don’t want to miss.

What are the early signs and symptoms of a ministroke?

Symptoms of a ministroke — or TIA — come on all of a sudden. The following are common early symptoms of a TIA.

1. One-sided weakness

Low blood flow to the brain causes weakness on one side of the face and/or body (like the arm or leg). You may notice weakness in just your face, arm, or leg — or all three.

If you experience facial weakness, you may notice:

Drooling
Trouble holding liquid in your mouth after taking a drink
Speech slurring

If you experience arm weakness, you may:

Drop things because you can’t hold onto them
Have trouble holding a cup or other objects
Have trouble lifting your arm

If you experience leg weakness, you may:

Notice that your foot drags when you walk
Have trouble rising from sitting to standing
Have trouble standing and maintaining your balance

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You may also notice numbness on one side of your body. This can feel like pins and needles along one side of your body. You may also feel completely numb.

2. Speech changes

You can experience speech changes if you develop a blockage in one of the blood vessels that goes to the speech center of your brain. Speech changes vary from person to person and may include:

Slurred speech
Difficulty finding words
Saying words that don’t make sense in the situation
Making sounds that others can’t understand as words

3. Confusion

You can also experience confusion if you have a blockage in a blood vessel that leads to your speech center. This affects your ability to understand language. People experiencing a ministroke may have trouble understanding what others are saying to them. This can make them seem confused and disoriented.

They might also:

Not know where they are
Not be able to use common objects, like a spoon
Not be able to follow directions

Keep in mind that people may not be able to describe what they’re experiencing because of confusion. If you notice that a loved one suddenly seems disoriented, it could be a sign of a ministroke.

4. Vision changes

People can develop vision changes because of a ministroke. This happens when a blood vessel that leads to the vision center of the brain gets blocked. People might also develop double vision if there’s less blood flow to the part of the brain that coordinates eye movement. Common vision changes that can develop with a ministroke include:

Double vision
Blurred vision
Complete vision loss

These vision changes can develop in one or both eyes. They usually start all of a sudden and aren’t painful.

5. Dizziness or balance problems

Dizziness and balance problems can develop when there’s less blood flow to the coordination center of the brain. As a result, people can’t sense where they are or how their body is moving through space. People describe feeling dizzy or like the room is spinning around them.

They may also walk into walls or doorways. Many people have trouble walking in a straight line or standing up straight. Some people aren’t able to hold their trunk steady when they're sitting down.

6. Headache

Up to 1 in 3 people experiencing a TIA develop headaches. But keep in mind that headaches are very common and can be triggered by many different things. A headache on its own is unlikely to be from a ministroke. Most people with TIAs will have other symptoms along with a headache.

What causes ministrokes (transient ischemic attacks)?

Ministrokes develop when blood flow to the brain gets blocked. This usually happens because a blood clot partially blocks a blood vessel (artery). In a TIA, the blood clot dissolves or moves on from where it was blocking blood flow.

Some medical conditions increase the risk of developing a ministroke like:

Smoking can also increase your risk of developing a ministroke because smoking injures blood vessels.

What should you do if you think you’re having a ministroke?

You should call 911 and get immediate medical care if you think you’re having a ministroke. It’s impossible to tell if you’re having a ministroke or stroke based on just your symptoms. If you’re having a stroke, you need to get care right away because strokes are life-threatening.

If a loved one develops symptoms of a ministroke, get help right away. Don’t wait to see if their symptoms get better or go away.

Healthcare professionals can get imaging studies, which will show if someone is having a stroke or a ministroke. They can also do other tests to see if your symptoms are from another medical condition.

A ministroke will get better on its own. But a ministroke is a sign that you’re at higher risk for developing a stroke in the future. In fact, 1 in 5 people who experience a ministroke develop a stroke within 90 days. If you’re having a ministroke, you’ll likely need other specialized tests to check the health of the blood vessels in your brain. Your healthcare team can help you find the right treatments to lower your risk of developing a stroke in the future.

Frequently asked questions

Medical conditions like seizures, migraines with aura, and fainting spells can cause symptoms like those of a ministroke. You should still seek immediate medical care for TIA symptoms even if you have one of these conditions. Your healthcare team can make sure your symptoms aren’t from a blocked blood vessel.

You may feel completely normal before you have a ministroke. Ministroke symptoms tend to come on all of a sudden. But some people’s symptoms start off more gradually. They may feel mild symptoms for a few minutes before the symptoms get worse.

People with a ministroke will need an MRI or CT of their brain and an electrocardiogram (ECG) to check their heart. Some people need specialized imaging of their blood vessels like a CT or magnetic resonance angiography (MRA). Most people also need blood tests. You may need additional tests and follow up with specialists after you leave the hospital.

The bottom line

A ministroke develops when there’s a temporary block in a blood vessel in the brain. Ministrokes (TIAs) can cause symptoms like one-sided weakness, speech difficulty, confusion, vision loss, and balance problems. These early warning signs start suddenly and go away on their own. But it’s impossible to tell if you’re having a ministroke or a stroke based on just your symptoms. That’s why it’s important to get immediate medical care if you’re having ministroke symptoms.

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Written by:

Amy Walsh, MD, MDP

Amy Walsh, MD, MDP, has worked as an emergency physician for 15 years, including care at both rural hospitals and trauma centers. She is the former Global Emergency Medicine fellowship director at Health Partners.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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