TIA Flashcards
What causes a TIA?
A transient obstruction of blood flow to the brain, spinal cord or retina
How long do the symptoms and signs of a TIA usually last?
Usually last for an hour
Will there be any evidence of acute infarction after a TIA?
No
The symptoms and signs of a TIA must have completely resolved within how long?
24 hours
The occurrence of a TIA suggests what?
Systemic atherosclerotic vascular disease and a high risk of stroke
What are the commonest causes of TIA?
Atheroembolism and cardioembolism
What are some risk factors for developing TIA?
Prior TIA/stroke, hypertension, AF, diabetes, history of IHD, smoking
Clinical features of a TIA depend on what?
The vascular territory which is affected
What are some clinical features (general) that a TIA could cause?
Cortical symptoms, speech abnormalities, visual field defects, cranial nerve involvement, memory disturbance
Amarousis fugax is caused by a TIA affecting which vessel?
Retinal artery
What happens in amarousis fugax?
A rapid, painless loss of vision ‘like a curtain coming down’
What is the main aim of investigation for TIA?
To identify the cause and determine the degree of risk
When a person presents with a TIA you should do a thorough clinical examination particularly including what things?
Listening for cardiac murmurs and arrhythmias and auscultating for carotid bruit
Which scoring system is used to guide the urgency of investigations and implementation of secondary measures for TIA?
ABCD2
What are the 5 features of the ABCD2 scoring system?
Age, blood pressure, clinical features, duration, diabetes
What are the 3 features of the ABCD2 scoring system which would always score a patient 1 point if present?
Age 60+, BP 140/90+, diabetes
How many points could patients score on the ABCD2 system for their clinical features?
If weakness = 2 points / if speech defect without weakness = 1 point
How many points could patients score on the ABCD2 system for the duration of their symptoms?
60+ minutes = 2 points / 10-59 minutes = 1 point
An ABCD2 score of 4 or more warrants what management?
Seen by a stroke specialist in 24 hours
An ABCD2 score of < 4 warrants what management?
Assessed and treated within 7 days
What are the 5 main investigations for TIA?
MRI brain, carotid doppler, ECG, ECHO, bloods
What blood tests are done for TIA and why?
FBC for blood disorders, renal function for renal failure, glucose for diabetes and CRP for vasculitis
What is the role of management of a TIA?
To reduce the risk of a stroke
What are some lifestyle measures that should be implicated following a TIA?
Smoking cessation, weight loss, exercise, decrease alcohol
What 3 things need to be well controlled following a TIA?
Hypertension, diabetes and cholesterol
What medical therapy is given following a TIA?
Anti-platelet
How is anti-platelet therapy given following a TIA?
Aspirin 300mg for 2 weeks, clopidogrel 75mg for life (or warfarin if cardioembolic)
What are some surgical management options which can be used for cardioembolic TIA?
Cardiac ablation for AF, valve repair/replacement for valvular disease, cardiac endarterectomy to remove plaques at the carotid bifurcation
