TIA

Question 1

Definition of a TIA

Answer 1

Neurological deficit lasting less than 24 hours attributable to cerebral or retinal ischaemia
Does not mean no brain damage

Question 2

Causes of TIA

Answer 2

Carotid artery disease/large artery disease
Cerebral small vessel disease
Cardiac embolism

Question 3

Conditions that mimic TIA

Answer 3

Migraine with aura
Seizure
Hypoglycaemia
Syncope
Acute confusional states

Question 4

Positive symptoms

Answer 4

Symptoms that are an increase in function e.g. limb shaking, flashing lights

Question 5

Negative symptoms

Answer 5

Symptoms that are a decrease in function e.g. loss of speech, loss of power in limbs

Question 6

Amarausis fugax

Answer 6

Retinal ischaemia

Question 7

Symptoms of posterior circulation TIA

Answer 7

Ataxia
Diplopia
Vertigo
Bilateral symptoms

Question 8

Symptoms of anterior circulation TIA

Answer 8

Amarausis fugax

Dysphasia

Question 9

ABCD2 score for TIA

Answer 9

Age (1 point for over 60)
BP (1 point for over 140/90)
Clinical features (2 for unilateral weakness, 1 for speech disturbance)
Duration of symptoms (2 for over 60 mins, 1 for 10-59 mins, 0 for under 10 minutes)
Diabetes (1 for yes)
Prognostic tool, not diagnostic

Question 10

Polypill

Answer 10

Theoretical pill
Combination of statin, aspirin, antihypertensives and folic acid
Could reduce risk of vascular events by 80%
Idea of improving compliance

Question 11

Carotid endarterectomy

Answer 11

For carotid territory TIA above iCA stenosis >70%

Does carry risks of stroke/death and nerve palsy

Question 12

Collaterals

Answer 12

Lowers risk

Especially occurs with 100% occulusion, making 75% occlusion often worse