Transient Ischemic Attack (TIA)

Samuel E. Mathis, MD and Kyu Jana, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A transient episode of neurologic dysfunction due to focal brain, retinal, or spinal cord ischemia without acute infarction

  • Most important predictor of stroke: 15% of patients with st...

DIAGNOSIS

HISTORY

  • Emphasis on symptom onset, progression, and recovery

  • Carotid circulation (hemispheric): monocular visual loss, hemiplegia, hemianesthesia, neglect, aphasia, visual field defects (amaur...

TREATMENT

GENERAL MEASURES

  • TIA is a neurologic emergency. Immediate medical attention should be sought within 24 hours of symptom onset due to increased stroke risk.

  • Current evidence suggests that patie...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Outpatient follow-up with neuro support every 3 months for 1st year and then annually

  • Close attention to recurrent TIA or subsequent CVA

DIET

  • DASH ...

REFERENCES

1 Zhao M, Wang S, Zhang D, et al. Comparison of stroke prediction accuracy of ABCD2 and ABCD3-I in patients with transient ischemic attack: a meta-analysis. J Stroke Cerebrovasc Dis.  ...

ADDITIONAL READING

  • Simmons BB, Cirignano B, Gadegbeku AB. Transient ischemic attack: part I. Diagnosis and evaluation. Am Fam Physician.  2012;86(6):521–526.  [View Abstract]

  • Simmons BB, Gadeqbek...

SEE ALSO

Algorithms: Stroke; Transient Ischemic Attack and Transient Neurologic Defects 

CODES

ICD10

  • G45.9 Transient cerebral ischemic attack, unspecified

  • G45.1 Carotid artery syndrome (hemispheric)

  • G45.0 Vertebro-basilar artery syndrome

  • G45.8 Oth transient cerebral ischemic attacks and relat...

CLINICAL PEARLS

  • Stress smoking cessation, exercise, weight loss, limited ETOH intake, and control of HTN, hyperlipidemia, and diabetes.

  • Antiplatelet therapy (e.g., aspirin, clopidogrel, or aspirin-dipy...

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