Treatment is aimed at preventing further TIAs and especially at preventing a stroke. The particular therapy depends on the root cause of the TIA and is not begun until this cause is identified. If at all possible, drug therapy is the preferred method of treating TIAs. Surgical intervention may be required if an individual's situation is not likely to respond to medication or if medication has failed.

Aspirin often is chosen for drug therapy. It is sometimes called a blood thinner because it blocks the function of platelets, the sticky cells that trigger blood clotting. Since aspirin can cause gastrointestinal side effects, other drugs may be prescribed. These drugs include dipyridamole or ticlopidine hydrochloride (Ticlid). Dipyridamole, which works by relaxing the smooth muscles of the arteries, is not as effective as aspirin. Ticlopidine hydrochloride is an anti-platelet drug that is slightly more effective than aspirin, especially in women. However, it may cause diarrhea or lowered blood cell counts. Blood tests must, therefore, be done frequently when patients are taking ticlopidine.

If carotid arteriography reveals at least a 70% blockage of the carotid artery, surgical treatment usually is recommended. The particular surgical method is called carotid endarterectomy. In endarterectomy, the artery is opened and the material clogging it is removed. Another procedure, called angioplasty, has been suggested for treating carotid stenosis, but it is not widely used. This procedure is performed by threading a thin tube through the blood vessel to the site that is clogged. A balloon or a stent (a slender rod) is then passed through the tube to mechanically widen the narrowed area. This procedure is successfully used in other blood vessels in the body, but there is some worry that using it close to the brain may be too dangerous. Surgical treatment of blockage of the vertebrobasilar arteries is not usually recommended.

Treatment of TIAs also focuses on underlying problems. High blood pressure, heart disease, and high levels of blood lipids all require medical intervention. Condition-specific medications often are prescribed and lifestyle changes are strongly encouraged. These changes include giving up smoking or excess alcohol consumption, engaging in physical exercise, and eating sensibly.