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Transient ischemic attack

Última revisão: 25 Mar 2025
Última atualização: 07 Mar 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • patient/caregiver report of focal neurologic deficit
  • sudden onset and brief duration of symptoms
Detalhes completos

Outros fatores diagnósticos

  • history of extracranial atherosclerosis
  • history of cardiac disease
  • unilateral symptoms
  • dysphasia
  • ataxia, vertigo, or loss of balance
  • vision loss or visual field deficit
  • binocular diplopia
  • increased BP on presentation
  • absence of positive symptoms (shaking, scotoma, spasm)
  • family or personal history of premature stroke, miscarriage, or venous thromboembolism
  • carotid bruit
Detalhes completos

Fatores de risco

  • atrial fibrillation
  • valvular disease
  • carotid stenosis
  • intracranial stenosis
  • congestive heart failure
  • hypertension
  • hyperlipidemia
  • diabetes mellitus
  • cigarette smoking
  • alcohol abuse
  • advanced age
  • patent foramen ovale (PFO)
  • inactivity
  • obesity
  • hypercoagulability
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • blood glucose
  • chemistry profile
  • CBC
  • prothrombin time, INR, and activated PTT
  • ECG
  • brain MRI with diffusion
  • fasting lipid profile
Detalhes completos

Investigações a serem consideradas

  • head CT
  • erythrocyte sedimentation rate (ESR)
  • telemetry/Holter monitor
  • echocardiogram ± bubble study
  • carotid Doppler ultrasound
  • CT angiography
  • magnetic resonance angiography (MRA)
  • transcranial Doppler
  • hypercoagulability studies
Detalhes completos

Algoritmo de tratamento

AGUDA

small-vessel TIA

cardioembolic TIA

stenosis of a major intracranial artery

mechanical heart valves or rheumatic heart disease already on therapeutic anticoagulation

Colaboradores

Autores

Lucia Chen, MD

Vascular Neurology Fellow

Department of Neurology

University of Colorado School of Medicine

Aurora

CO

Declarações

LC declares that she has no competing interests.

Jennifer Simpson, MD
Jennifer Simpson

Associate Professor

Department of Neurology

University of Colorado School of Medicine

Aurora

CO

Declarações

JS declares that she has no competing interests.

Karen Orjuela, MSCR, FAAN

Assistant Professor

Department of Neurology

University of Colorado School of Medicine

Aurora

CO

Declarações

KO has received research funding from the Bristol Myers Squibb Foundation and Abbott.

Agradecimentos

Dr Lucia Chen, Dr Jennifer Simpson, and Dr Karen Orjuela wish to gratefully acknowledge Dr Ethan Cumbler, a previous contributor to this topic.

Declarações

EC declares that he has no competing interests.

Revisores

Ronan Factora, MD

Staff Physician

Section of Geriatric Medicine

Cleveland Clinic

Cleveland

OH

Declarações

RF declares that he has no competing interests.

Tony Rudd, MD

Stroke Physician

Guy's and St Thomas' NHS Foundation Trust

Stroke Programme Director

Royal College of Physicians

London

UK

Declarações

TR declares that he has no competing interests.

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