Transient ischemic attack: New clinical and imaging findings

Up to now, patients with a transient ischemic attack (TIA) were often referred to a delayed and incomplete diagnostic and therapeutic workup because of the only transient nature of their symptoms. In this overview new clinical and imaging findings will be presented that underscore the concept that a TIA represents a neurological emergency. The stroke risk after a TIA is high, particularly during the acute phase (3.9 to 5.5% during the first 48 hours, 10.5 to 12% during one month) and requires a rapid evaluation of the etiology, an initial monitoring of the patient, a risk factor oriented secondary prevention, because effective treatment options were available (e.g. CEA for carotid stenosis, anticoagulation for atrial fibrillation). The short time risk after a TIA can be estimated with an easy clinical score (ABCD score). New MRI techniques enable to select TIA patients with an unstable clinical course and an elevated acute risk for subsequent stroke. Particularly endangered are TIA patients with lesions seen in the diffusion-weighted MRI and a symptom duration of more than I hour or the detection of intracranial stenosis. Patients with TIA are threatened through cardiac complications during the long-term and need a sustained optimization of their cardiovascular risk factors.     «

Up to now, patients with a transient ischemic attack (TIA) were often referred to a delayed and incomplete diagnostic and therapeutic workup because of the only transient nature of their symptoms. In this overview new clinical and imaging findings will be presented that underscore the concept that a TIA represents a neurological emergency. The stroke risk after a TIA is high, particularly during the acute phase (3.9 to 5.5% during the first 48 hours, 10.5 to 12% during one month) and requires a...     »