Transient ischaemic attack

Question 1

What is a transient ischaemic attack?

Answer 1

Brief episode of neurological dysfunction due to temporary focal cerebral or retinal ischaemia without infarction, e.g. a weak limb, aphasia or loss of vision, usually lasting seconds or minutes with complete recovery; symptoms last less than ~24 hours

Question 2

What is the usual cause of TIA?

Answer 2

Microemboli

Question 3

How will TIA present?

Answer 3

• Sudden loss of function, usually lasting for minutes only, with complete recovery and no evidence of infarction on imaging
• Amaurosis fugax

Question 4

What investigations are required in TIA?

Answer 4

History
Carotid duplex scanning
ECG
Blood tests

Question 5

How is TIA managed?

Answer 5

• Immediate antiplatelet therapy
• Secondary prevention interventions - antihypertensive therapy, statins
• Surgery and stenting for carotid stenosis