Stroke - TIA Flashcards
What timeframe of symptoms is classed as a TIA, rather than a stroke ?
patient fully recovers before diagnosis is made and within 24 hrs (usually much faster - minutes!)
What are the symptoms of a TIA ?
all the same symptoms of a stroke, but very acute and they self correct within minutes-24hrs
Do the symptoms of a TIA come on gradually or suddenly ?
suddenly!
if symptoms gradually worsen or spread across the body, it is unlikely to be a TIA
What is classed as a ‘crescendo TIA’ ?
2 or more TIAs within a week
Does a TIA usually cause loss of consciousness ?
no
What are some conditions that can cause similar symptoms to a TIA ?
- syncope - although TIA doesn’t usually cause total LOC
- atypical seizures - can cause unilateral weakness but are usually repetitive unlike a TIA
- migraine - symptoms usually evolve over time and include headache
- temporal arteritis - temporal and jaw pain with visual impairment
- retinal haemorrhage or detachment - can cause unilateral vision loss
- hypoglycaemia - can cause neuro disturbances
- labyrinthine disorders/vertigo - present with dizziness that is uncommon in TIA
- stroke recrudescence - re-emergence/worsening of previous stroke symptoms due to infection or illness. it is not caused by a new stroke
If a GP suspects a TIA, what should they do ?
- explain diagnosis to patient
- prescribe aspirin
- refer urgently to TIA clinic for assessment within 24hrs
Which investigation is not required in the case of a TIA ?
CT brain
only required if neuro deficits persist, Pt is on anticoags or a different diagnosis is suspected
What investigations should be done at a TIA clinic ?
- Carotid doppler to check for stenosis as a modifiable stroke risk factor
- ECG to look for underlying AF
- Blood work to assess for underlying risk factors
- HbA1c to detect and manage underlying diabetes as a risk factor
What scoring system is used to assess a patients risk of stroke when they have AF ?
CHADS-VASC score
What is a carotid endarterectomy?
the surgical removal of plaques from the carotid arteries, in order to prevent strokes
What is the recommended treatment for patients experiencing TIAs with known AF ?
anticoagulation asap
(rather than anti platelets e.g aspirin or clopidogrel)
What is dysphasia ?
difficulty speaking
Describe the progression of symptoms in inter cranial haemorrhage ?
progressive over minutes to hours
Where is weakness most likely to occur in a stroke affecting the ACA (anterior cerebral artery) ?
ACA = legs
