Transient Ischemic Attack as a Medical Emergency
Transient Ischemic Attack (TIA) is a vascular emergency that requires a specialized, systematic evaluation to confirm the diagnosis of an ischemic mechanism, identify high-risk source of brain ischemia and initiate a therapeutic strategy. It is important to distinguish whether the patient has a transient cerebral/ocular ischemic or a non-ischemic mimicking event. Patients with suspected TIA need an urgent neurological evaluation within 12 hrs, comprehensive neuroimaging work-up, preferably with MRI, cervical/cerebral vascular imaging, and basic cardiac evaluation (ECG). Treatment options include anticoagulation for atrial fibrillation, carotid revascularization for symptomatic carotid artery stenosis, antiplatelet therapy, and vascular risk factor reduction strategies. A TIA should be treated as a medical emergency, as up to 80% of strokes after TIA are preventable.
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