TIA Flashcards
What is a transient ischaemic attack (TIA)?
A TIA is a temporary neurological deficit caused by transient disruption of cerebral blood flow without causing permanent damage.
What are the key symptoms of a TIA?
Sudden onset of weakness, numbness, speech difficulties, vision problems, or loss of coordination that resolves within 24 hours.
What is the typical duration of TIA symptoms?
Symptoms usually resolve within minutes to a few hours and always within 24 hours.
What causes a TIA?
It is caused by transient embolic or thrombotic obstruction of blood flow in a cerebral artery.
How does a TIA differ from a stroke?
Unlike a stroke, a TIA does not result in permanent neurological damage.
What are the risk factors for a TIA?
Hypertension, diabetes, smoking, atrial fibrillation, hyperlipidaemia, and a history of cardiovascular disease.
What is the prevalence of TIA?
TIA is common, with a significant risk of progressing to a stroke if untreated, particularly within the first 48 hours.
What is the ABCD2 score?
A clinical tool used to estimate the risk of stroke following a TIA, considering Age, Blood pressure, Clinical features, Duration of symptoms, and Diabetes.
What are the components of the ABCD2 score?
Age ≥60 years, Blood pressure ≥140/90 mmHg, Clinical features (unilateral weakness or speech disturbance), Duration of symptoms, and Diabetes.
What investigations are typically done for TIA?
Blood tests, ECG, brain imaging (CT or MRI), carotid Doppler, and echocardiography.
What is the role of CT or MRI in TIA evaluation?
Imaging helps to exclude stroke, assess for underlying pathologies, and detect signs of recent infarction.
Why is carotid Doppler used in TIA investigations?
To assess for carotid artery stenosis, which may be a source of emboli.
What ECG findings are relevant in TIA?
Atrial fibrillation or other arrhythmias that increase the risk of embolic events.
What are the differential diagnoses for TIA?
Migraine aura, focal seizures, hypoglycaemia, vertigo, or multiple sclerosis.
What is the acute management of TIA?
Immediate antiplatelet therapy (e.g., aspirin) and urgent specialist assessment.
What long-term medications are used to prevent strokes following a TIA?
Antiplatelets (aspirin or clopidogrel), anticoagulants (if atrial fibrillation is present), antihypertensives, and statins.
What lifestyle changes are recommended after a TIA?
Smoking cessation, regular exercise, a healthy diet, maintaining a healthy weight, and reducing alcohol intake.
What surgical intervention might be indicated for TIA?
Carotid endarterectomy for significant carotid artery stenosis.
Why is a TIA considered a medical emergency?
Because it significantly increases the risk of a subsequent stroke, particularly within the first 48 hours.
What are the clinical features most predictive of TIA?
Sudden onset of unilateral weakness, speech disturbance, or visual loss.
What are the potential complications of untreated TIA?
Progression to a stroke, permanent disability, or death.
What is the significance of early intervention in TIA?
Early intervention can reduce the risk of stroke by addressing modifiable risk factors and initiating preventive treatments.
What imaging modality is most sensitive for detecting TIA-related changes?
Diffusion-weighted MRI.
What is the purpose of echocardiography in TIA evaluation?
To identify cardiac sources of emboli, such as left atrial thrombus or patent foramen ovale.
How is atrial fibrillation managed in TIA patients?
With anticoagulation therapy to reduce the risk of embolic strokes.
