Diagnosis and Management of Transient Ischemic Attack
- PMID: 28157745
- PMCID: PMC5898963
- DOI: 10.1212/CON.0000000000000424
Diagnosis and Management of Transient Ischemic Attack
Abstract
Purpose of review: This article reviews the diagnosis, investigation, and recommended management after a transient ischemic attack (TIA) and discusses how to make an accurate diagnosis, including the diagnosis of mimics of TIAs.
Recent findings: Up to a 10% risk of recurrent stroke exists after a TIA, and up to 80% of this risk is preventable with urgent assessment and treatment. Imaging of the brain and intracranial and extracranial blood vessels using CT, CT angiography, carotid Doppler ultrasound, and MRI is an important part of the diagnostic assessment. Treatment options include anticoagulation for atrial fibrillation, carotid revascularization for symptomatic carotid artery stenosis, antiplatelet therapy, and vascular risk factor reduction strategies.
Summary: TIA offers the greatest opportunity to prevent stroke that physicians encounter. A TIA should be treated as a medical emergency, as up to 80% of strokes after TIA are preventable.
References
-
- Hankey GJ, Warlow CP. Treatment and secondary prevention of stroke: evidence, costs, and effects on individuals and populations. Lancet 1999;354(9188):1457–1463. doi:10.1016/S0140-6736(99)04407-4. - PubMed
-
- Rothwell PM, Warlow CP. Timing of TIAs preceding stroke: time window for prevention is very short. Neurology 2005;64(5):817–820. doi:10.1212/01.WNL.0000152985.32732.EE. - PubMed
-
- Easton JD, Saver JL, Albers GW, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke 2009;40(6):2276–2293. doi:10.1161/STROKEAHA.108.192218. - PubMed
-
- Albers GW, Caplan LR, Easton JD, et al. Transient ischemic attack—proposal for a new definition. N Engl J Med 2002;347(21):1713–1716. doi:10.1056/NEJMsb020987. - PubMed
-
- Kraaijeveld CL, van Gijn J, Schouten HJ, Staal A. Interobserver agreement for the diagnosis of transient ischemic attacks. Stroke 1984;15(4):723–725. doi:10.1161/01.STR.15.4.723. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Molecular Biology Databases
Research Materials