- The American Heart Association released a statement urging people who experience stroke-like symptoms to receive an emergency assessment for stroke.
- They noted that 10-18% of those with a ‘transient stroke’ have a stroke within 90 days.
- They hope their guidelines will help clinicians improve the care provided to those at risk of stroke.
Transient ischemic attack (TIA) happens when stroke-like symptoms occur for a few minutes or hours and then disappear. Just like a stroke, symptoms usually begin suddenly.
The exact number of TIA cases in the U.S. is difficult to determine due to its transient nature and lack of standardized surveillance. However, estimates suggest that at least
Research also suggests that
TIA is a temporary blockage of blood flow to the brain. Almost half of the strokes in those following a TIA occur within two days. For this reason, TIA is often described as a ‘warning stroke’. Symptoms include:
- face drop on one side
- inability to lift both arms and keep them there due to weakness or numbness
- slurred or garbled speech or inability to speak
- complete paralysis on one side of the body
- sudden vision loss, blurred vision, or double vision
- problems with balance and coordination
Risk factors for TIA
- family history of stroke or TIA
- being age 55 or older
- being male
- high blood pressure
- smoking tobacco
“Confidently diagnosing a TIA is difficult since most patients are back to normal function by the time they arrive at the emergency room,” said Dr. Hardik P. Amin, associate professor of neurology, medical stroke director at Yale New Haven Hospital, St. Raphael Campus in New Haven, Connecticut, and one of the study’s authors in a press release.
“There also is variability across the country in the workup that TIA patients may receive. This may be due to geographic factors, limited resources at healthcare centers, or varying levels of comfort and experience among medical professionals,” he added.
Dr. Hardik noted that the AHF statement was written to help healthcare professionals differentiate between TIA and ‘TIA mimics’. TIA mimics share similar symptoms with TIA’s but results from other medical conditions, including low blood sugar, seizures, or migraines.
Upon entering the emergency room, the AHA recommends a non-contrast head CT scan to rule out intracerebral hemorrhage or TIA mimics. However, they noted it has limited utility in patients whose symptoms have
They noted that magnetic resonance imaging (MRI) should also be used to distinguish TIA from stroke and that it should be carried out within 24 hours of symptom onset for best results. Around
The researchers wrote that if MRI is available, a non-contrast CT scan may be skipped.
Next, they recommended blood tests to rule out conditions such as low blood sugar or infections and to check for cardiovascular risk factors, including diabetes and high cholesterol.
They also recommended an electrocardiogram to assess heart rhythm and for patients to receive an early neurology consultation within 48 hours to a week of symptom onset.
The ABCD2 score
To assess for stroke risk after TIA, the AHA recommends the 7-point
- blood pressure
- clinical features (symptoms)
- duration of symptoms
- diabetes status
The researchers noted that there are