[What should be done after the first TIA?]

Abstract

Transient ischaemic attacks (TIA) are neurological events caused by temporary cerebrovascular disorders whose effects can be fully reversed within 24 hours. TIAs are forewarnings of an impending stroke. On the average, 15% of the patients suffer a stroke within 90 days after a TIA; half of the strokes occur within the first 48 hours. This necessitates very prompt diagnosis that includes medical examination, determination of risk factors, ultrasound examination of the cerebral vessels, cerebral imaging, ECG and echocardiography. Secondary prevention includes administering platelet inhibitors or, in case of cardiogenic embolism, oral anticoagulants, treatment of vascular risk factors and a change in lifestyle. Surgical or interventional therapy is indicated if severe stenosis of the cerebral arteries is present.