TIA

Question 1

What is TIA

Answer 1

TISSUE BASED
a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischaemia, without acute infarction

no acute infarction on imaging.

Question 2

assessment of TIA

When is the Mx contraindicated

Answer 2

Immediate antithrombotic therapy:
give aspirin 300 mg immediately, unless

1. the patient has a bleeding disorder or is taking an anticoagulant (needs immediate admission for imaging to exclude a haemorrhage)
2. the patient is already taking low-dose aspirin regularly: continue the current dose of aspirin until reviewed by a specialist
3. Aspirin is contraindicated: discuss management urgently with the specialist team

Question 3

antithrombotic therapy?

Answer 3

• clopidogrel is recommended first-line (as for patients who’ve had a stroke)
• aspirin + dipyridamole should be given to patients who cannot tolerate clopidogrel

Question 4

carotid artery endarterectomy guidelines

Answer 4

recommend if patient has suffered stroke or TIA in the carotid territory and are not severely disabled

should only be considered if carotid stenosis > 70% according ECST* criteria or > 50% according to NASCET** criteria

Question 5

Ix for TIA

Answer 5

ECG for AF or MI
CT/MRI
ECHO
fasting blood lipids/cholestrol
glucose
autoantibody profile