11 – Neuro – TIA
TIA – Transient Ischemic Attack Notes by Nick O'Hanlon, SPT What is it? The same underlying mechanism as an ischemic stroke; with the main difference being the duration of symptoms is significantly less In other words, a brief episode of neurological dysfunction caused by ischemia (lack of blood supply) to the brain No tissue death occurs Signs and Symptoms Clinically presents like a stroke, but can also look like: a seizure disorder, tumor, migraines, or hypoglycemia Stroke symptoms – slurred speech, paralysis, overactive reflexes, balance and coordination issues, reduced sensation A complete resolution of symptoms occurs within 24 hours Anatomy Dependent on an area of the brain the ischemic attack occurs, but any part of the brain Crescendo TIAs – having more than one TIA within a specified time period 2 within 24 hours 3 within 3 days 4 within 2 weeks Special Tests Imaging – CT/MRI Clinical Exam – ABCDD2 prediction rule, which can predict risk of stroke after a TIA Age, >60 years BP, >140/90 Clinical presentation: unilateral weakness with or without speech impairment Duration of symptoms Diabetes Above a certain point threshold for the rule, patient is at increased risk for a stroke Differential Diagnosis Can present similarly to stroke, but the duration of symptoms for a stroke is much longer Causes Risk factors for TIA include: smoking, high blood pressure, high cholesterol, diabetes, and family history Treatment examples Treating the person as they present with their impairments There is a good possibility the duration of symptoms is too short for us to see them during the dysfunctional window before resolution of symptoms Education about risk factors and crescendo TIAs How does it look on the test? ABCDD prediction rule is important to know Be able to differentiate between TIA and stroke
