TIA Flashcards
What is a TIA
temporary disruption of blood flow to the brain that causes rapid onset of neurological deficit that lasts less than 24 hours
epidemiology of TIA
15% of first strokes are preceded by TIA
M > F
Black ethnicity is at greater risk due to their hypertension and atherosclerosis predisposition
20, 000 people have a TIA
Cause of TIA pathology
Cerebral ischaemia is a common cause causing lack of O2 and nutrients causing cerebral dysfunction
Short lived
Symptoms lasting max 5-15 mins after onset then resolves before cell death
Gradual progression of symptoms suggest different pathology
Causes of TIA
Artherothromboembolism
Small vessel occlusion
Cardioembolism
Hyperviscosity
Risk factors
Previous TIA Age Hypertension Smoking Diabetes Heart disease Peripheral arterial disease
Symptoms of TIA
Sudden loss of function w complete recovery
Stroke symptoms FAST
90% of TIAs affect
Anterior circulation (carotid)
Contra lateral weak numb leg
Hemi sensory disturbance
Dysphasia inability to produce speech
10% of TIAs affect
Posterior circulation vertebasilar artery Vertigo Vomiting Choking Ataxia
Differential diagnosis
Impossible to differentiate from stoke until full recovery Hypoglycaemia Labrynthine disorders Mass lesions Migranious aura
Measuring risk of stroke
ABCD^2 score Risk score of stroke A-age 1 B- blood pressure 1 C- clinical features - unilateral weakness 2 speech disturbance 1 D-duration 60mins> 2 10-59 1 D-diabetes
High risk= AF, score of 4 or more, TIA more than one in a week or on anticoagulants
Investigations of TIA
MRI
Catatonic Doppler - stenosis
ECG
CT angiography- stenosis
Management of TIA
Modifiable -drinking smoking diet exercise Low risk- Specialist assessment w/in 7 days Start statin - simvastatin 40mg Antiplatlet unless taking anticoagulant -clopidogrel 300mg Treat BP if raised No driving High risk is same but within 24 hrs Aspirin immediately for both
