TIA

Question 1

Cerebrovascular Disease

Answer 1

Transient Ischemic Attack

• Acute, focal cerebral insufficiency < 24 hrs
• Usually < 60 min
• No residual effects

Stroke

• Neurological deficits
• Lasts > 24 hrs

Question 2

TIA: Stuff

Answer 2

49/100,000

Males more than females

Increased risk for stroke
-highest risk within 1 month of TIA

Question 3

TIA prevention

Answer 3

Varies patient to patient, but recurrent TIA’s usually similar

Onset and recovery abrupt

Symptoms are associated with location of defect

Follow a vascular ‘line’
-if you follow blocked vessel to area of brain, symptoms will be of that portion of brain

Question 4

TIA vs Bell’s Palsy

Answer 4

Bells Palsy: drooping face

-requires treatment unlike TIA

Question 5

TIA presentation: Carotid Area

Answer 5

Carotid Area

• weakness, heaviness in contralateral arm, leg, or face
• Numbness
• DYSPHAGIA (swallowing)
• Ipsilateral monocular visual loss

Question 6

TIA presentation: Vertebrobasilar Area

Answer 6

Vertebrobasilar area
-Dim or blurry vision
-Vertigo
-DYSPHASIA (speaking)
-Ataxia
-Motor or sensory changes
(ipsilateral face) same side
(contralateral body) crosses midline

Question 7

TIA Diagnosis

Answer 7

History and physical

• identify any pattern, history
• Any vascular changes

CT, MRI, or MRA
-Rule out hemorrhage, lacunar infarcts or aneurysms

Carotid doppler studies
-Carotid stenosis

ECHO
-Assess for cardiac source

Question 8

TIA: treatment

Answer 8

Depends on etiology

Anticoagulation

• ASA (no benefits of high dose) 1500mg/day
• Clopidogrel (Plavix)
• Heparin and warfarin if cardiac related

Carotid endarterectomy with >70 % stenosis

Carotid angioplasty
-baloon