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Transient ischemic attack

Last reviewed: 18 Jun 2025
Last updated: 07 Mar 2024

Summary

Definition

病史和体格检查

关键诊断因素

  • patient/caregiver report of focal neurologic deficit
  • sudden onset and brief duration of symptoms
完整详情

其他诊断因素

  • 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
完整详情

危险因素

  • 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
完整详情

诊断性检查

首要检查

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

需考虑的检查

  • 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
完整详情

治疗流程

急症处理

small-vessel TIA

cardioembolic TIA

stenosis of a major intracranial artery

mechanical heart valves or rheumatic heart disease already on therapeutic anticoagulation

撰稿人

作者

Lucia Chen, MD

Vascular Neurology Fellow

Department of Neurology

University of Colorado School of Medicine

Aurora

CO

利益声明

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

利益声明

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

利益声明

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

鸣谢

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

利益声明

EC declares that he has no competing interests.

同行评议者

Ronan Factora, MD

Staff Physician

Section of Geriatric Medicine

Cleveland Clinic

Cleveland

OH

利益声明

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

利益声明

TR declares that he has no competing interests.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021 Jul;52(7):e364-467.全文  摘要

Turan TN, Zaidat OO, Gronseth GS, et al. Stroke prevention in symptomatic large artery intracranial atherosclerosis practice advisory: report of the AAN Guideline Subcommittee. Neurology. 2022 Mar 22;98(12):486-98.全文  摘要

Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019 Dec;50(12):e344-418.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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