Transient Ischemic Attack (Mini-Stroke) (cont.)
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Transient Ischemic Attack (TIA) Diagnosis
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The diagnosis of TIA is most often made by history, since the neurologic deficits have most likely resolved before the patient presents for care. This history will also try to identify risk factors for heart disease and stroke:
Physical examination will include monitoring heart rate and rhythm and listening to the heart and lungs. Examination of the neck may include listening for bruits (abnormal sound made by blood rushing through narrowed blood vessels) or sounds made by blood rushing through narrowed blood vessels. A full neurologic exam will be undertaken and may include looking for weakness or numbness; assessing walk and coordination; and checking vision, hearing, speech, and language comprehension.
Other tests that may be considered include:
Basic blood tests may include a CBC (complete blood count) to look for anemia or problems with too many or too few platelets. Patients who take warfarin (Coumadin) (a blood thinner to prevent blood clots from atrial fibrillation) will have their blood tested to make certain the medication dosage is appropriate.
If there is concern that there may be clots coming from the heart or debris coming from heart valves, then an echocardiogram (ultrasound examination of the heart) may be indicated to help with the diagnosis as to the origin of the TIA.
Transient Ischemic Attack (TIA) Treatment
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Treatment of TIA is aimed at preventing a future stroke. Simple scoring systems have been developed to estimate this risk and help decide whether a patient should be admitted to the hospital for observation or whether they can be discharged home for observation.
ABCD and ABCD2 (diabetes is considered) scores are commonly used predictors.
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