Is it possible that a headache can be the only symptom of a transient ischemic attack (TIA, mini-stroke)?

Let’s say the headache even lasts just a few minutes.

What are the odds that this could have been a TIA (transient ischemic attack), especially if you have risk factors for one of these mini-strokes?

Headaches and TIAs

“Approximately 25% of all TIAs present with headache as a prominent complaint, and yes, it can be the only symptom of a TIA,” begins Rob Lapporte, MD, board certified in emergency medicine and chief medical officer of Physician 360, a telemedicine service.

“However, this is rare.  Usually there is a speech deficit or a motor deficit, such as weakness or facial droop.”

So for instance, a sudden-onset headache that comes at the same time as double vision, in a person who has risks for a transient ischemic attack, are very worrisome symptoms.

This individual should go to the ER as soon as possible, even if the headache and visual disturbance last for only 10 seconds!

Very short duration of TIA symptoms is NOT related to the seriousness of the underlying cause.

So whether that headache, coupled with some other neurological symptom such as one-sided heaviness, lasts only 10 seconds or 30 minutes, the urgency to get to an ER is the same.

A sudden headache that’s full force, like a thunderclap, is a warning to get to the ER as soon as possible—and by ambulance.

This is far more likely to be the immediately life-threatening burst blood vessel in the brain (ruptured aneurysm or hemorrhagic stroke), than a transient ischemic attack or ischemic stroke.

Risk factors and ways to reduce the possibility of having a TIA are the same as that for a stroke, such as controlling blood pressure, structured exercise and not smoking.

And remember, headaches can have many causes.

Dr. Lapporte has been practicing evidence-based clinical medicine in emergency rooms and urgent care centers for almost 20 years.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: Shutterstock/Ruslan Huzau