Commonly asked questions in transient ischemic attack

Abstract

With the advent of modern neuroimaging techniques, transient ischemic attack (TIA) has been redefined as, "a transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischemia, without acute infarction." If infarct is evident on neuroimaging, the event is a stroke. It is important to recognize and correctly diagnose TIA and minor stroke because of the substantial early risk of stroke. Much of the early stroke risk is attributable to large artery atherosclerosis. Stroke-risk stratification in TIA patients can be done based on clinical grounds using an ABCD(2) score. There is, however, abundant data to support inclusion of neuroimaging in stroke-risk determination, which can also be combined with a clinical risk assessment. The hybrid ABCDE⊕ score further refines early stroke risk. Rapid assessment and treatment in the emergency department or in specially designed 'TIA clinics' appear to reduce stroke rate.