TIA

Question 1

what is TIA

Answer 1

causes symptoms similar to a stroke but the symptoms last for less than 24 hours. It is due to a temporary lack of blood to a part of the brain. In most cases, a TIA is caused by a tiny blood clot that becomes stuck in a small blood vessel (artery) in the brain. This blocks the blood flow and a part of the brain is starved of oxygen. The affected part of the brain is without oxygen for just a few minutes and soon recovers. This is because the blood clot either breaks up quickly or nearby blood vessels are able to compensate.

Question 2

Dx for transient neurological function

Answer 2

TIA
focal seizure
migraine aura
focal disturbance of cortical function
- hypoglycaemia
- chronic subdural haematoma

Question 3

initial Mx of suspected and confirmed TIA

Answer 3

aspirin 300mg

refer immediately to TIA clini within 24 hours of onset of Sx

Question 4

when do u do brain imaging

Answer 4

determine the territory of ischaemia, or to detect haemorrhage or alternative pathologies. If MRI is done, perform it on the same day as the assessment.

Question 5

when do u give a patient carotid endarterectomy

Answer 5

ECST criteria above 70%

Question 6

why would immediate aspirin be contradicted

Answer 6

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 7

long term Mx of TIA

Answer 7

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