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Stroke is the third-leading cause of death in the United States each year, writes Dr. Paul Lucas, director of the Vascular Laboratory at Mercy Medical Center. It's the second-leading cause of cardiovascular death and the most common cause of death as a result of neurological disorders. Approximately one out of every eight strokes is preceded by a transient ischemic attack, or TIA. This is a warning stroke of sorts. Lucas discusses how to recognize such an attack, and what to do about it.

* A TIA, by definition, is a medical term for a group of neurological symptoms - for instance weakness or numbness - which appears suddenly and then resolves completely within 24 hours. These are caused by a temporary lack of blood flow within an area of the brain. The symptoms can vary depending on what area of the brain is affected.

TIAs can develop from heart problems such as atrial fibrillation, from plaque buildup in the carotid arteries in the neck, or from problems within the brain.

* A TIA may be a warning sign of an impending stroke. In fact, the risk for stroke within two days of a TIA is thought to be between 4 percent and 10 percent.

A TIA can be a single occurrence, or several TIAs can occur at varying times. The most common symptoms experienced during a TIA are numbness or weakness (in the face, tongue, hand, arm or leg), slurring of speech or difficulty speaking; blurred vision or decreased vision in one eye.

* Risk factors for TIA/stroke are: advancing age; smoking; diabetes; hypertension; atrial fibrillation (irregular heartbeat); hyperlipidemia (high cholesterol and/or triglycerides); obesity; prior cardiovascular events; and illegal drug use.

Anyone with a family history of TIA or strokes, is over the age of 50 and has risk factors should discuss risk reduction measures with a doctor. Free carotid screening tests are also available.

* Anyone who experiences a TIA should seek medical attention immediately; it is a medical emergency and should be promptly evaluated.

* Many strokes can be prevented, and timing is critical in the evaluation and treatment of a TIA.

Various studies and imaging modalities are employed during the work-up and many of the local hospitals are equipped with stroke teams and protocols to help expedite patient evaluation and institution of appropriate therapies.

Treatment and therapies vary from antiplatelet therapy (aspirin, etc.) to anticoagulation therapy (warfarin sodium), thrombolytics (clot busters) or revascularization.

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