Diagnosis and Management of Transient Ischemic Attack

Shelagh B. Coutts, MD, MSc, FRCPC Cerebrovascular Disease p. 82-92 February 2017, Vol.23, No.1 doi: 10.1212/CON.0000000000000424
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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.

Address correspondence to Dr Shelagh Coutts, Foothills Medical Centre, 1403 29th St NW, C1242, Calgary, AB, Canada T2N 2T9, [email protected].

Relationship Disclosure: Dr Coutts receives research/grant support from the Canadian Institutes of Health Research (CRH-112319), the Heart and Stroke Foundation of Canada (G-16-00012585), and Genome Canada (143TIA-Penn).

Unlabeled Use of Products/Investigational Use Disclosure: Dr Coutts reports no disclosure.

Copyright © 2017 by the American Academy of Neurology.