Transient ischemic attack

Transient ischemic attack (TIA) is a neurological event characterized by a temporary interruption of blood flow to the brain. This disruption results in an acute, but transient, loss of cerebral function that lasts less than 24 hours. Commonly referred to as a "mini-stroke," a TIA may serve as a warning sign for a potential future stroke.

Introduction

Transient ischemic attacks (TIAs) are brief episodes of neurological dysfunction resulting from an interruption in the blood supply to the brain, spinal cord, or retina, without acute infarction. The symptoms of a TIA are similar to those of a stroke but are transient, lasting less than 24 hours. Despite the transient nature of the symptoms, TIAs are associated with a significant risk of subsequent stroke.<ref>Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA, 2000.</ref>

Causes and Risk Factors

The cause of a TIA is the temporary decrease or cessation of blood flow to a part of the brain, typically due to a clot in the blood vessels. Risk factors for TIAs are similar to those for strokes and include hypertension, diabetes mellitus, smoking, hyperlipidemia, and atrial fibrillation.<ref>Coull AJ, Rothwell PM. Underestimation of the early risk of recurrent stroke: evidence of the need for a standard definition. Stroke, 2004.</ref>

Symptoms

The symptoms of a TIA depend on the part of the brain affected. These can include temporary loss of sensation or movement (usually on one side of the body), difficulties with speech or vision, confusion, loss of balance, or sudden, severe headache.<ref>Coutts SB. Diagnosis and management of transient ischemic attack. Continuum (Minneap Minn), 2017.</ref>

Diagnosis

The diagnosis of a TIA is primarily based on the patient's medical history and clinical examination. In addition, brain imaging (usually with a CT scan or MRI), carotid ultrasound, electrocardiogram (EKG), and blood tests may be used to identify the cause of the TIA and to evaluate the risk of stroke.<ref>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. Stroke, 2009.</ref>

Management and Treatment

Management of TIA aims to prevent a subsequent stroke. This generally includes the use of antiplatelet drugs (such as aspirin), control of risk factors (like hypertension and diabetes), and sometimes surgery (like carotid endarterectomy). Lifestyle modifications such as quitting smoking, exercising regularly, and eating a healthy diet are also important.<ref>Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2014.</ref>

See also

• Stroke
• Hypertension
• Diabetes mellitus
• Atrial fibrillation
• Carotid endarterectomy

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