A 🆕 scientific statement from the AHA offers a standardized approach to rapidly evaluate patients with suspected transient ischemic attack:
- dizziness with cranial neuropathies, vision loss, trouble with coordination/gait, truncal ataxia, severe nausea- altered mentationIf available, a non-contrast head computed tomography scan should be done initially in the emergency department to evaluate for subacute ischemia, hemorrhage, or mass lesion. Although the sensitivity of NCCT to detect an acute infarct is low, NCCT is useful for ruling out TIA mimics, the writing group says.
"When MRI cannot be obtained acutely to definitively distinguish TIA from stroke, it remains reasonable to make a clinical diagnosis of TIA in the ED on the basis of a negative NCCT and symptom resolution within 24 hours," the authors say. The statement also provides guidance on the advantages, limitations, and considerations of doppler ultrasonography, computed tomography angiography, and magnetic resonance angiography for TIA assessment.
An individual's risk of future stroke after TIA can be rapidly assessed using the ABCD2 score, which stratifies patients into low, medium, and high risk based on age, blood pressure, clinical features, duration of symptoms and diabetes.
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