Transient Ischaemic Attack

Question 1

What is a TIA?

Answer 1

Sudden neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia, without evidence of acute infarction, lasting less than 24 hours.

Question 2

What scoring tool is used to predict risk of stroke in the days following a TIA?

Answer 2

ABCD2 scoring tool
A - Age > 60 = 1 point
B - Blood pressure >140/90 = 1 point
C - Clinical features (unilateral features = 2, speech disturbance w/o weakness = 1)
D - Duration of symptoms (>60 mins = 2, 10-59 mins = 1)
D - Diabetic = 1 point

Score 4+ = high risk of stroke

Question 3

How is TIA managed acutely if the ABCD2 score is 4+ or crescendo TIA (2+ in a week)?

Answer 3

300 mg aspirin stat then 75mg clopidogrel OD. See in TIA clinic within 24 hours - confirm Dx then start secondary prevention.

Question 4

How is TIA managed acutely if the ABCD2 score is less than 4?

Answer 4

See in TIA clinic within 7 days, 300mg aspirin.

Start secondary prevention (consider clopidogrel/low dose aspirin/statins)