TIA (1)

Question 1

What is it?

What does it increase the risk of?

What are its causes?

How does it present?

Answer 1

➊ Sudden onset focal neurological deficit of vascular aetiology, with symptoms lasting < 24 hrs (usually < 1 hr) and no evidence of acute infarct on imaging

➋ Full Stroke

➌ • Carotid embolism
• Cardioembolism - AF or Mural thrombus post-MI
• Hyperviscocity - Polycythaemia, Sickle cell

➍ • Focal neurological deficit - e.g. dysphasia, limb weakness, sensory loss
• Absence of positive symptoms suggestive of differentials e.g. shaking preceding the weakness
• Absence of headache, which suggests migraine or intracranial bleeding

Question 2

What are the investigations to do?

How is it managed?

Answer 2

➊ • Glucose
• ECG
• Bloods - FBC, U&Es, CRP, Clotting

➋ • Immediate Aspirin 300mg for 14 days
• Switch to Clopidogrel 75mg for long-term prevention
• Atorvastatin 20-80mg
• Optimise control of other risk-factors