TIA

Question 1

What is a TIA?

Answer 1

A transient ischaemic attack (TIA) is a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischaemia, without acute infarction. (Complete resolution in 24 hrs)

Question 2

What are the risk factors for a TIA?

Answer 2

> AF
> Valvular disease
> Carotid stenosis
> Congestive Heart Failure
> Hypertension
> Diabetes Mellitus
> Cigarette smoking
> Alcohol abuse
> Advanced Age

Question 3

What is the epidemiology of a TIA?

Answer 3

Stroke is a major health concern in the UK that accounts for 11% of all deaths in England and Wales. Each year in England 2000 people have a first episode of TIA.

Question 4

What are the signs and symptoms of a TIA?

Answer 4

> Brief
> Extracranial atherosclerosis
> Unilateral symptoms
> Increased BP on presentation
> Focal neurological deficit
> Absence of positive symptoms or headache
> History of migraine

Question 5

What investigations do you use for a TIA?

Answer 5

> Bloods
>> Glucose (rule out hypo)
>> Chemistry (abnormality may suggest non ischaemic)
>> FBC (normal)
>> Clotting profile (normal)
> ECG (AF?)
> Brain MRI (may have positive diffusion images)
> Fasting lipid profile

Question 6

What is the management of a TIA?

Answer 6

> Antiplatelet therapy (aspirin)
Statin (atorvastatin)
Ezetimibe (if artherosclerotic heart disease)

Question 7

What are the complications of a TIA?

Answer 7

> Stroke

> MI

Question 8

What is the prognosis of a TIA?

Answer 8

By definition, a patient with a TIA has no residual symptoms from the primary event. The most significant risk to the patient is a second ischaemic event causing permanent disability.