Transient Ischemic Attack (TIA)
A transient ischemic attack (TIA) is a transient stroke that lasts only a few minutes. It occurs when the blood supply to part of the brain is briefly interrupted. TIA symptoms which usually occur suddenly are similar to those of stroke but do not last as long. Most symptoms of a TIA disappear within an hour
You do not know if it is a stroke or TIA!
Both are emergencies! Call 911 and get help NOW!
Patients in whom TIA is diagnosed in the emergency department have high immediate and short-term risks of stroke. TIA is under-investigated (not enough tests are done) and undertreated (people are not prescribed preventative medications). Make sure that you get proper treatment
What do I do if I have a TIA?
- Go to Emergency immediately. Doctors there should schedule all the tests that they would to determine why a stroke has occurred and put you on preventative medication. You have a very high risk of having a major stroke within the next few hours, days or weeks
- Ensure that the hospital does all the tests and make a determination before being discharged
- Ensure you have preventative medications that match the medical determination before being discharged
- Take the preventative medications as prescribed
- Change those risk factors you have control over! Stop smoking, control blood pressure with medication, control blood sugar if you are a diabetic
- Take prescribed medications to prevent stroke
You are at much higher risk of a stroke if you have been having TIAs
- One out of three people who have a TIA will have a stroke
- Approximately 60% of strokes occur in patients who have had a previous TIA. For more information go to the Internet Stroke Center
If you have had a TIA (transient ischemic attack) your risk of stroke is
- 5% within the first two days after a TIA (Lindgren A, Norrving B, Thornqvist MLakartidningen (2004 Mar 18;101(12):1102-6)
- 8 % 1st month after a TIA
- 12 % in the first year after a TIA
- 24- 29% in 5 years after a TIA
- For more information go to Risk of stroke after TIA
Research
TIA patients did not receive treatments to prevent stroke nor were the minimum recommended diagnostic tests done within 30 days (Gladstone, Kapral, Fang Laupacis, Tu CMAJ March2004)
Patients diagnosed with TIA have high immediate or short term risks of stroke but their condition was under-investigated and undertreated
- More than 1/3 of patients were discharged without a prescription for antithrombotic therapy
- Three-quarters of the TIA patients were discharged from the emergency department. After discharge, the 30-day stroke risk was
- 5% overall and 8% among those with a first-ever TIA
- the 30-day risk of stroke or death was 9% among the TIA patients with a speech deficit and 12% among those with a motor deficit
- Half of the cases of stroke occurred within the first 2 days after the TIA.
- Diagnostic investigations were underused in hospital and on an outpatient basis within 30 days after the index TIA, the rates being as follows
- CT scanning 58%
- Carotid Doppler ultrasound 44%
- Echocardiography 19%
- Cerebral angiography 5%
- MRI 3%
To read the entire article Early risk of stroke after a TIA.pdf
Information
Using Transcranial Doppler to Determine Stroke Risk The high frequency of early stroke following TIA has resulted in the recent publication of guidelines in the UK. The guidelines recommend that patients attend a neurovascular clinic within 7 days of the index event to expedite investigation and treatment and so reduce the risk of a subsequent (potentially more serious) neurological event. After a TIA or stroke caused by carotid-artery disease, there is an increase in cerebral microemboli detectable by transcranial doppler (TCD). High microembolic loads appear to be surrogate markers for future neurological events, and the pharmacological efficacy of therapeutic interventions can now be rapidly and non-invasively assessed
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