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Transient Ischemic Attack (TIA)

Farha K. Syed, MD and Samuel E. Mathis, MD Reviewed 06/2019
 


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

  • Follow-up with neurologic support every 3 months for 1st year and then annually

  • Close attention to recurrent TIA or subsequent CVA

DIET

  • DASH diet o...

REFERENCES

1
Coutts SB. Diagnosis and management of transient ischemic attack. Continuum (Minneap Minn).  2017;23(1):82–92. [View Abstract on OvidMedline]
2
Fang JX, Wang EQ, Wang W, et al. Efficacy...

ADDITIONAL READING

  • Kernan WN, Ovbiagele B, Black HR, et al; for American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on ...

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

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

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

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