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13 Cards in this Set
- Front
- Back
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What is a transient ischemic attack?
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A brief episode of neurological dysfunction caused by focal brain or retinal ischemia, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction
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What is wrong with the definition of a transient ischemic attack?
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It undermines the urgency of recognizing a TIA as an important warning of impending stroke and facilitating rapid evaluation and treatment to prevent permanent brain ischemia
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What is the common clinical presentation of TIA?
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*Sudden weakness, numbness or paralysis in the face, arm or leg
*Slurred or garbled speech or difficulty understanding others *Sudden blindness or double vision *Dizziness, loss of balance or coordination *Psychiatric or cognitive deficits |
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What are ominous signs of an impending stroke?
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Neurologic symptoms that crescendo with increasing frequency, duration, or severity
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If a patient reports symptoms of a possible TIA, what should you do?
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Direct the patient to the nearest emergency dept if they have had symptoms for less than 180 mins
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What is the initial workup for suspected TIA?
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Confirm TIA history --> Did acute symptoms occur < 24 to 48 hours --> Is patient a candidate for thrombolytic therapy?
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What are the differentials of TIA?
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Migraine, seizure, postictal states, tumors and glucose derangement and rarely MS (in young patients) and ALS (in older patients); migraines can be difficult to distinguish from TIA's
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What are modifiable risk factors for stroke?
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HTN, diabetes, elevated lipids, cardiac disease, carotid artery stenosis, smoking, alcohol use, obesity, physical inactivity
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What should all patients with a possible TIA receive?
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Detailed documented neurologic exam
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What is the purpose of a CT scan in assessing TIA?
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Identifies hemorrhage and hematomas, masses/tumors; not used for examing the brain stem
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What is the purpose of an EKG in assessing TIA?
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Establish baseline EKG and find abnormalities that are risk factors for stroke
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What is the purpose of obtaining an ESR?
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Rule out vasculitis
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What is the gold standard for complete evaluation of intracranial and extracranial vessels?
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Cerebral angiography, indicated for suspected carotid artery dissection
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