Transient Ischaemic Attacks (4)

Question 1

TIA

Answer 1

Neurological defect

Question 2

Causes of TIA

Answer 2

• Large/carotid artery disease
• Cerebral small vessel disease
• Cardiac embolism

Question 3

What percentage of strokes will be preceded by a TIA?

Answer 3

20%

Question 4

How common are TIAs?

Answer 4

5/10,000 population

Question 5

TIA/stroke mimics

Answer 5

Seizures, Syncope, Migraines, Hypoglycaemia, Acute confusional states

Question 6

Anterior Circulation TIA

Answer 6

Amarausis fugax (transient monocular visual loss), Dysphasia, Apraxia, Inattention

Question 7

Posterior Circulation TIA

Answer 7

Ataxia, Vertigo, Diplopia, Bilateral symptoms

Question 8

Posterior/Anterior Circulation TIA

Answer 8

Visual field disturbances (hemianopia), Hemiparesis (weakness on one side of body), Hemisensory loss, Dysarthria

Question 9

ABCD2

Answer 9

Age 1 > 60yrs

BP 1 > 140/90

Clinical 2 unilateral weakness
1 speech disturbance

Duration 2 > 60mins
1 10-59 mins
0

Question 10

Reoccurrence of TIA

Answer 10

5 High risk

Question 11

Investigations

Answer 11

History, exam, bloods - glucose

Question 12

Drugs to prevent reoccurrence

Answer 12

Statin, Aspirin, Anti-hypertensive, Folic acid

Question 13

Secondary vascular prevention

Answer 13

Carotid endarterectomy - remove plaque

Question 14

Risks of carotid endarterectomy

Answer 14

Stroke/death 3-5% or Nerve palsy (greater auricular/superior laryngeal/hypoglossal)