11 – Neuro – TIA

TIA – Transient Ischemic Attack

Notes by Nick O'Hanlon, SPT

What is it?

The same underlying mechanism as an ischemic stroke; with the main difference being the duration of symptoms is significantly less

In other words, a brief episode of neurological dysfunction caused by ischemia (lack of blood supply) to the brain

No tissue death occurs

Signs and Symptoms

Clinically presents like a stroke, but can also look like: a seizure disorder, tumor, migraines, or hypoglycemia

Stroke symptoms – slurred speech, paralysis, overactive reflexes, balance and coordination issues, reduced sensation

A complete resolution of symptoms occurs within 24 hours

Anatomy

Dependent on an area of the brain the ischemic attack occurs, but any part of the brain

Crescendo TIAs – having more than one TIA within a specified time period

2 within 24 hours

3 within 3 days

4 within 2 weeks

Special Tests

Imaging – CT/MRI

Clinical Exam – ABCDD2 prediction rule, which can predict risk of stroke after a TIA

Age, >60 years

BP, >140/90

Clinical presentation: unilateral weakness with or without speech impairment

Duration of symptoms

Diabetes

Above a certain point threshold for the rule, patient is at increased risk for a stroke

Differential Diagnosis

Can present similarly to stroke, but the duration of symptoms for a stroke is much longer

Causes

Risk factors for TIA include: smoking, high blood pressure, high cholesterol, diabetes, and family history

Treatment examples

Treating the person as they present with their impairments

There is a good possibility the duration of symptoms is too short for us to see them during the dysfunctional window before resolution of symptoms

Education about risk factors and crescendo TIAs

How does it look on the test?

ABCDD prediction rule is important to know

Be able to differentiate between TIA and stroke