Ataque isquêmico transitório
Summary
Definition
History and exam
Key diagnostic factors
- início súbito e breve duração dos sintomas (minutos)
- relato de paciente/testemunha de deficit neurológico focal
Other diagnostic factors
- fraqueza unilateral ou paralisia
- disfasia
- ataxia, vertigem ou perda do equilíbrio
- perda súbita e transitória da visão em um olho (amaurose fugaz)
- hemianopsia homônima
- diplopia
- fatores de risco
Risk factors
- fibrilação atrial
- valvopatia
- estenose da carótida
- estenose intracraniana
- insuficiência cardíaca congestiva
- hipertensão
- hiperlipidemia
- diabetes mellitus
- tabagismo
- transtornos decorrentes do uso de bebidas alcoólicas
- idade avançada
- forame oval patente (FOP)
- sedentarismo
- obesidade
- hipercoagulabilidade
Diagnostic tests
1st tests to order
- glicose sanguínea
- hemograma completo e contagem de plaquetas
- tempo de protrombina, INR, tempo de tromboplastina parcial
- perfil lipídico em jejum
- eletrólitos séricos
- eletrocardiograma (ECG)
Tests to consider
- Tomografia computadorizada (TC)
Treatment algorithm
suspeita de ataque isquêmico transitório
ataque isquêmico transitório confirmado
Contributors
Expert advisers
Matthew Jones, MD, FRCP
Consultant Neurologist
Manchester Centre for Clinical Neurosciences
Northern Care Alliance
Honorary Senior Lecturer
University of Manchester
Manchester
UK
Disclosures
MJ is the chair of the Association of British Neurologists Education Committee (unpaid position). MJ is a faculty member of a MRCP revision course and has received honoraria from Eisai for educational talks.
Rachael Power, MBChB, MRCP
Neurology Registrar
Manchester Centre for Clinical Neurosciences
Manchester
UK
Disclosures
RP declares that she has no competing interests.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work is retained in parts of the content:
Jennifer Simpson, MD
Associate Assistant Professor
Department of Neurology
University of Colorado School of Medicine
Denver
CO
Disclosures: JS is a site investigator for the POINT trial.
Ethan Cumbler, MD
Associate Professor
Section of Hospital Medicine
Department of Internal Medicine
Division of Medicine
University of Colorado School of Medicine
Denver
CO
Disclosures: EC declares that he has no competing interests.
Peer reviewers
Kayvan Khadjooi, MD, FRCP, PGCertMedEd
Consultant in Stroke Medicine
Addenbrooke’s Hospital
Associate Lecturer
School of Clinical Medicine
University of Cambridge
Cambridge
UK
Disclosures
KK has received travel grants for conferences/speaker honoraria from Bayer, Boehringer, Daiichi-Sankyo, Pfizer, and Shire.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
National Institute for Health and Care Excellence. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management. Apr 2022 [internet publication].Full text
Royal College of Physicians; Scottish Intercollegiate Guidelines Network; Royal College of Physicians of Ireland. National clinical guidelines for stroke for the United Kingdom and Ireland. April 2023 [internet publication].Full text
Reference articles
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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