Transient Ischaemic Attack (TIA)

Brief episode of neurological dysfunction due to temporary focal cerebral or retinal ischaemia without infarction, e.g. a weak limb, aphasia or loss of vision, usually lasting seconds or minutes with complete recovery; symptoms last less than ~24 hours

Aetiology

  • Usually the result of microemboli

Clinical presentation

  • Sudden loss of function, usually lasting for minutes only, with complete recovery and no evidence of infarction on imaging
  • Amaurosis fugax - sudden transient loss of vision in one eye
    • A TIA causing an episode of amaurosis fugax is often the first clinical evidence of internal carotid artery stenosis - a warning sign of incipient ICA territory stroke

Investigations

  • History - diagnosis of TIA is often based solely on its description
  • Carotid duplex ultrasound
  • ECG
  • Blood tests

Management

  • Immediate antiplatelet therapy
  • Secondary prevention interventions - antihypertensive therapy, statins
  • Surgery and stenting for carotid stenosis