Transient Ischaemic Attack Flashcards
What is it?
Sudden onset of focal CNS phenomena that last less than 24 hours
What causes it?
Temporary occlusion of part of the cerebral circulation
What causes the occlusion? (4)
Atherthromboembolism from the carotid, Cardioembolism post-MI or from AF, Hyperviscosity of the the blood e.g Polycythaemia, Vasculitis
Is it common?
Quite, it affects 50 people per 100,000 each year
Who does it affect?
More common with increasing age and tends to affect more men
Risk Factors (10)
Age, hypertension, smoking, diabetes, Polycythaemia, OCP, Carotid Atheroma, Hyperlipidaemia, Excess alcohol, clotting disorders
Symptoms (5)
*Mimics a stroke, Cognitive speech and movement impairments, amaurosis fugax, changes in behaviour
What score is used in a TIA?
The ABCD2 score
What does this score stand for?
Age >60, Blood Pressure >140/90, Clinical features e.g unilateral weakness and speech disturbance, Duration, Diabetes
Differentials
Hypoglycaemia, Migraine, Focal epilepsy, Hyperventilation
What bloods would you do? (7)
FBC, ESR, CRP, U&E, LFT, Glucose, Lipids
Other investigations
CT, MRI, CXR, ECG, Carotid Doppler, Carotid Angiography, ECHO, EEG
What is the treatment? (9)
Need to prevent it from happening again by controlling the risk factors. Clopidogrel and aspirin, ACE inhibitors/Ca blockers, B-Blocker, Statin
Can perform a Carotid Endarterectomy to clear any atheroma
Smoking cessation, weight loss, reduce alcohol intake
Avoid driving for 1 month
How long are TIA patients at risk of a stroke?
They have a much higher risk of stroke for 1 year after a TIA
Is there a good prognosis?
The risk of a stroke in untreated Carotid Stenosis is >70% so TIAs need to be treated. 60% of TIA patients die within 10 years
