jtemplate.ru - free extensions for joomla

Transient Ischemic Attack

A transient ischemic attack, or TIA, represents a temporary loss of blood flow to a particular area of the brain, brainstem or (rarely) spinal cord. The event can last up to 24 hours, but typically is just a few seconds or minutes in duration. Symptoms may include an abrupt loss of speech, change in gait, alteration in vision, localized weakness, or sensory change such as numbness or tingling. Often, the symptoms involve one side of the body, including the face, arm and leg.

TIA risk factors include hypertension, diabetes mellitus, hyperlipidemia, arrythmias such as atrial fibrillation, carotid artery disease, smoking, alcohol abuse, and less common conditions such as vasculitis, patent foramen ovale, bleeding disorders, collagen vascular diseases and arterial dissection. Some other conditions such as migraine, epilepsy and subdural hematoma may mimic a TIA.

A TIA should be considered a medical and neurologic emergency, as up to 5-10% of patients can experience recurrent symptoms or even a severe stroke within hours to days. If a TIA is suspected, 911 should be called immediately, and the patient should be transported to the closest emergency room, preferably one associated with a Comprehensive or Primary Stroke Center. In many cases, it is not unreasonable to have the patient take an aspirin tablet immediately, even while en route to the hospital.

The usual workup includes brain imaging such as MR or CT, ultrasound testing, trans-thoracic and/or trans-esophageal echocardiography, and fasting laboratory testing. Occasionally, invasive angiography will be recommended. There are a variety of treatment options including antiplatelet medications, anticoagulants, internal carotid artery surgery or stenting, and of great importance, risk factor assessment and management.