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Encyclopedia > Transient ischemic attack
Transient ischemic attack
Classification & external resources
ICD-10 G45, I60-I69
ICD-9 435
DiseasesDB 13253
MedlinePlus 000730
eMedicine emerg/604 

A transient ischemic attack (TIA, often colloquially referred to as "mini stroke") is caused by the temporary disturbance of blood supply to a restricted area of the brain, resulting in brief neurologic dysfunction that usually persists for less than 24 hours. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Italic text // ahh addiing sum spiice iin hurr`` For other uses, see Brain (disambiguation). ...

Contents

Symptoms

Symptoms vary widely from person to person depending on the area of the brain involved. The most frequent symptoms include temporary loss of vision (typically amaurosis fugax), difficulty speaking (dysarthria), weakness on one side of the body (hemiparesis), numbness usually on one side of the body, and loss of consciousness. If there are neurological symptoms persisting for more than 24 hours, it is classified as a cerebrovascular accident (stroke). Amaurosis (Greek meaning darkening, dark, or obscure) is vision loss or weakness that occurs without an apparent lesion affecting the eye [1]. It may result from either a medical condition or from excess acceleration, as in flight. ... Look up dysarthria in Wiktionary, the free dictionary. ... Hemiparesis is the partial paralysis of one side of the body. ... A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted by occlusion (an ischemic stroke- approximately 90% of strokes), by hemorrhage (a hemorrhagic stroke - less than 10% of strokes) or other causes. ...


Prognosis

Patients diagnosed with a TIA are sometimes said to have had a warning for an approaching cerebrovascular accident. If the time period of blood supply impairment lasts more than a few minutes, the nerve cells of that area of the brain die and cause permanent neurologic deficit. One third of the people with TIA later have recurrent TIAs and one third have a stroke due to permanent nerve cell loss. Stroke is the clinical designation for a rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain. ...


The ABCD2 score can predict likelihood of subsequent stroke.[1][2] Stroke is the clinical designation for a rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain. ...


The score is calculated as:

  • Age ≥ 60 years = 1 point
  • Blood pressure at presentation ≥ 140/90 mm Hg = 1 point
  • Clinical features
unilateral weakness = 2 points
speech disturbance without weakness = 1 point
  • Duration of attack
≥ 60 minutes = 2 points
10–59 minutes = 1 point
  • Diabetes = 1 point

Interpretation of score, the risk for stroke within 2 days:

  • Score 0-3 = 1% risk
  • Score 4-5 = 4% risk
  • Score 6–7 = 8% risk

Causes

The most common cause of a TIA is an embolus (a small blood clot) that occludes an artery in the brain. This most frequently arises from an atherosclerotic plaque in one of the carotid arteries (i.e. a number of major arteries in the head and neck) or from a thrombus (i.e. a blood clot) in the heart due to atrial fibrillation. In medicine, an embolism occurs when an object (the embolus, plural emboli) migrates from one part of the body (through the circulation) and cause(s) a blockage (occlusion) of a blood vessel in another part of the body. ... In pathology, an atheroma (plural: atheromata) is an accumulation and swelling (-oma) in artery walls that is made up of cells, or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. ... In human anatomy, the carotid artery is a major artery of the head and neck. ... Blood clot diagram. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ...


Other reasons include excessive narrowing of large vessels due to an atherosclerotic plaque and increased blood viscosity due to some blood diseases. TIA is related with other medical conditions like hypertension, heart disease (especially atrial fibrillation), migraine, cigarette smoking, hypercholesterolemia, and diabetes mellitus. Blood diseases affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins, the mechanism of coagulation, etc. ... This article or section does not cite any references or sources. ... Heart disease is an umbrella term for a number of different diseases which affect the heart and is the leading cause of death in the United States as of 2007. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... Tobacco smoking is the act of smoking tobacco products, especially cigarettes and cigars. ... Hypercholesterolemia (literally: high blood cholesterol) is the presence of high levels of cholesterol in the blood [1]. It is not a disease but a metabolic derangement that can be secondary to many diseases and can contribute to many forms of disease, most notably cardiovascular disease. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ...


Prevention

Primary prevention

 The use of anti-coagulant medications such as aspirin, heparin and warfarin. 

Secondary prevention

Tertiary prevention

Treatment

The mainstay of treatment following acute recovery from a TIA should be to diagnose and treat the underlying cause. It is not always immediately possible to tell the difference between a CVA (stroke) and a TIA. Most patients who are diagnosed at a hospital's Accident & Emergency Department as having suffered from a TIA will be discharged home and advised to contact their primary physician to organize further investigations. The emergency department (ED), sometimes termed the emergency room (ER), emergency ward (EW), accident & emergency (A&E) department or casualty department is a hospital or primary care department that provides initial treatment to patients with a broad spectrum of illnesses and injuries, some of which may be life-threatening and...


An electrocardiogram (ECG) may show atrial fibrillation, a common cause of TIAs, or other arrhythmias that may cause embolisation to the brain. An echocardiogram is useful in detecting thrombus within the heart chambers. Such patients benefit from anticoagulation. “QRS” redirects here. ... The echocardiogram is an ultrasound of the heart. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ...


If the TIA affects an area supplied by the carotid artery, an ultrasound (TCD) scan may demonstrate carotid stenosis. For people with a greater than 70% stenosis within the carotid artery, removal of atherosclerotic plaque by surgery, specifically a carotid endarterectomy, may be recommended. Ultrasound is a form of cyclic sound pressure with a frequency greater than the upper limit of human hearing, this limit being approximately 20 kilohertz (20,000 hertz). ... Transcranial Doppler (TCD) is a test that measures the velocity of blood flow through the brains blood vessels. ... A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure. ... Carotid entarterectomy is a surgical procedure used to correct carotid stenosis (obstruction of the carotid artery by atheroma), used particularly when this causes medical problems, such as transient ischemic attacks (TIAs) or cerebrovascular accidents (CVAs, strokes). ...


Some patients may also be given modified release dipyridamole or clopidogrel. Dipyridamole is a drug that inhibits platelet aggregation and causes vasodilation. ... Clopidogrel (IPA: ) is a potent oral antiplatelet agent often used in the treatment of coronary artery disease, peripheral vascular disease, and cerebrovascular disease. ...


References

  1. ^ Johnston SC, Rothwell PM, Nguyen-Huynh MN, et al (2007). "Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack". Lancet 369 (9558): 283-92. DOI:10.1016/S0140-6736(07)60150-0. PMID 17258668. 
  2. ^ Rothwell PM, Giles MF, Flossmann E, et al (2005). "A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack". Lancet 366 (9479): 29-36. DOI:10.1016/S0140-6736(05)66702-5. PMID 15993230. 

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links


  Results from FactBites:
 
► Transient ischemic attack (TIA) (655 words)
Transient ischemic attack (TIA, "little stroke") is a warning that the body's safety mechanisms are overloaded and indicates that a stroke may be pending.
A TIA is caused by a temporary state of reduced blood flow (ischemia) in a portion of the brain.
Less common causes of TIA include blood disorders (including polycythemia, sickle cell anemia, and hyperviscosity syndromes where the blood is very thick), spasm of the small arteries in the brain, abnormalities of blood vessels caused by disorders such as fibromuscular dysplasia, inflammation of the arteries (arteritis, polyarteritis, granulomatous angiitis), systemic lupus erythematosus, and syphilis.
AANOS, An Article by Professor Fathie (3106 words)
Transient ischemic attacks are usually described as related to the carotid or vertebral-basilar arterial systems.
The classic history for transient ischemic attack in the carotid system is one of swift onset of contralateral weakness or numbness of the arm or leg.
Transient ischemic attack produces a neurological deficit, the onset of which is usually sudden with gradual progression of the symptomatology.
  More results at FactBites »

 
 

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