Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- patient/caregiver report of focal neurologic deficit
- sudden onset and brief duration of symptoms
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
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
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
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
Algoritmo de tratamento
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

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.
Diagnósticos diferenciais
- Stroke
- Hypoglycemia
- Seizure with post-seizure (Todd's) paralysis
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: cerebrovascular disease
- Stroke prevention in symptomatic large artery intracranial atherosclerosis practice advisory
Mais DiretrizesFolhetos informativos para os pacientes
Stroke: treatment
Stroke caused by a blood clot: preventing another stroke
Mais Folhetos informativos para os pacientesCalculadoras
NIH Stroke Score
ABCD2 Score to Predict Stroke Risk after TIA
Mais CalculadorasVideos
Venepuncture and phlebotomy: animated demonstration
How to perform an ECG: animated demonstration
Mais vídeosConectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal