Related Experiment Videos
Transient ischemic attack: definition and natural history.
1Cerebrovascular Disease Service, Palmer 127, West Campus, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA. lcaplan@bidmc.harvard.edu
Current Atherosclerosis Reports
|July 11, 2006
Summary
The definition of transient ischemic attack (TIA) is updated. TIAs are brief neurological events from focal ischemia, lasting under an hour, without infarction, requiring urgent investigation and tailored treatment.
Area of Science:
- Neurology
- Vascular Neurology
- Cerebrovascular Disease
Background:
- The traditional definition of transient ischemic attack (TIA) is outdated and arbitrary.
- Clinical experience indicates TIAs are typically shorter than 24 hours and can be associated with brain infarction.
Purpose of the Study:
- To propose a revised, more accurate definition of transient ischemic attack (TIA).
- To emphasize the need for urgent evaluation and investigation in patients presenting with TIA symptoms.
Main Methods:
- Review of existing literature and clinical data on transient ischemic attacks (TIAs).
- Comparison of the standard definition with newer data and proposed revisions.
- Outline of recommended diagnostic workup for suspected TIAs.
Main Results:
- The standard TIA definition (≤24 hours) is no longer considered tenable.
- A revised definition emphasizes brief neurological dysfunction (<1 hour) due to focal ischemia without infarction.
- Urgent evaluation including neuroimaging, vascular imaging, blood tests, and cardiac investigations is crucial.
Conclusions:
- A new definition of transient ischemic attack (TIA) better reflects clinical reality.
- Prompt and comprehensive investigation is essential for patients with suspected TIAs.
- Treatment strategies for TIAs must address underlying cervico-cranial vascular, cardiac, and hematologic abnormalities.