Transient Ischaemic Attacks

Question 1

Define: Transient Ischaemic Attack

Answer 1

Sudden onset, focal neurological deficit lasting

Question 2

What are the causes of TIA?

Answer 2

Same as stroke
> Vascular - Large and small arteries
> Cardiac embolism

Question 3

What is the incidence of TIAs?

Answer 3

50/100,000 = same incidence as stroke

Question 4

What are some symptoms of TIA mimics?

Answer 4

> Hypoglycaemia 
> Migraine
> Seizures 
> Syncope 
> Acute confusional states

Question 5

What symptoms determine whether a TIA is anterior circulation? (HINT: Think what lobes it supplies)

Answer 5

> Amarausis Fugax - Transient vision loss
Dysphasia
Inattention
Apraxia

Question 6

What symptoms determines whether a TIA is posterior circulation?

Answer 6

> Ataxia - loss of balance
Diplopia
Vertigo

Question 7

Why do bilateral symptoms indicate a posterior circulation TIA?

Answer 7

Because of damage to the brainstem - it controls both sides of the body.

Question 8

What symptoms indicate the TIA could be in either circulation?

Answer 8

> Hemianopia
Hemiparesis
Hemi sensory loss
Dysarthria

Question 9

What is the ABCD2 score for Stroke/TIA?

Answer 9

Age > 60 (1 pt)
BP >140/90 (1 pt)
Clinical Features : Unilateral weakness (2 pts), Speech disturbance (1 pt)
Duration: >60 mins (2 pts),

Question 10

What drugs make up the Polypill (to reduce vascular event incidence) ?

Answer 10

> Anti-hypertensives
Aspirin
Statins
DONT FORGET: FOLIC ACID

Question 11

When is a Cartoid Endarterectomy done? (inside removal of stenosis)

Answer 11

For carotid territory TIA above 70% stenosis.

Question 12

What are the risks of a Carotid Endarterectomy?/

Answer 12

Death/stroke

Nerve palsy.