A transient ischemic attack is a transient episode of neurologic dysfunction caused by ischemia (loss of blood flow) either focal brain,

, spinal cord or retinal without acute infarction (tissue death). TIAs share the same underlying etiology (cause) as strokes: a disruption of cerebral blood flow (CBF), and are frequently referred to as mini-strokes. TIAs and strokes cause the same symptoms, such as contralateral paralysis (opposite side of body from affected brain hemisphere) or sudden weakness or numbness. A TIA may cause sudden dimming or loss of vision (amaurosis fugax), aphasia, slurred speech and mental confusion. But unlike a stroke, the symptoms of a TIA can resolve within a few minutes or 24 hours. Brain injury may still occur in a TIA lasting only a few minutes. Having a TIA is a risk factor for eventually having a stroke or a silent stroke.[1][2] A silent stroke or silent cerebral infarct (SCI) differs from a TIA in that there are no immediately observable symptoms. A SCI may still cause long lasting neurological dysfunction affecting such areas as mood, personality and cognition. A SCI often occurs before or after a TIA or major stroke.[3] A cerebral infarct that lasts longer than 24 hours but fewer than 72 hours is called a reversible ischemic neurologic deficit or RIND.

Signs and symptoms Symptoms vary widely from person to person, depending on the area of the brain involved. The most frequent symptoms include temporary loss of vision (typically amaurosis fugax); difficulty speaking (aphasia); weakness on one side of the body (hemiparesis); and numbness or tingling (paresthesia), usually on one side of the body. Impairment ofconsciousness is very uncommon. There have been cases of temporary and partial paralysis affecting the face and tongue of the afflicted. The symptoms of a TIA are short-lived and usually last a few seconds to a few minutes and most symptoms disappear within 60 minutes. Some individuals may have a lingering feeling that something odd happened to the body. Dizziness, lack of coordination or poor balance are also symptoms related to TIA. Symptoms vary in severity.
[edit]Causes

The most common cause of a TIA is an embolus that occludes an artery in the brain. This usually arises from a

dislodged atherosclerotic plaque in one of the carotid arteries (i.e.two of the four major arteries supplying the brain) or from a thrombus (i.e. a blood clot) in the heart because of atrial fibrillation. In a TIA, the blockage period is very short-lived and hence there is no permanent damage.[4] The cholesterol build-up is gradual and eventually narrows the lumen. With time, blood flow to that side of the brain is reduced and a stroke may result. In other cases, cholesterol particles from the atherosclerotic plaque may suddenly break off and enter the brain. In some people, these fragments come off from theheart and go to the brain. This often happens during a heart attack or an infection of the valves.[5] Other reasons include excessive narrowing of large vessels resulting from an atherosclerotic plaque and increased blood viscosity caused by some blood diseases. TIA is related to other medical conditions such as hypertension, heart disease (especially atrial fibrillation), migraine, cigarette smoking, hypercholesterolemia, and diabetes mellitus.
[edit]Risk

factors

Family history of stroke or TIA substantially increases risk. People 55 years or older are at higher risk. Males have a slightly higher risk of TIA than females but females are more likely to die from a stroke. African Americans generally tend to have a high risk of dying from a stroke, chiefly due to high blood pressure and uncontrolled diabetes.[6]
[edit]Diagnosis

TIA will usually be diagnosed after a doctor performs a history and a physical exam. There are several radiological tests that are done to evaluate patients who have had a TIA. This includes a CT scan or an MRI of the brain, ultrasound of the neck, an echocardiogram of the heart. In most cases, the source of atherosclerosis is usually identified with anultrasound.[7]
[edit]Differential

diagnoses

Other diagnoses may have symptoms similar to those of a TIA: Atypical migraine if visual symptoms occur such as perception of wavy or jagged lines or tiny specks of light and if a headache occurs.[citation needed] Typically a history of prior migraines is present. 2. Partial seizure in the parietal area of the brain 3. Glucose abnormalities; these could be distinguished by a history of diabetes mellitus and a loss of consciousness 4. Electrolyte abnormalities 5. Hypertensive encephalopathy (headache, delirium, hypertension, cerebral edema) 6. Subdural hematoma (history of trauma, headache, loss of consciousness) 7. Brain tumor (mode of onset, progressive headaches, increased intracranial pressure) 8. Demyelinating disease 9. Conversion disorder
1.
[edit]Prevention

A TIA may be prevented by changes in lifestyle; although most of these recommendations have no solid empirical data, most medical professionals believe them to be so[8]. These include: Avoiding smoking Cutting down on fats and cholesterol to help reduce plaque build up Eating a healthy diet including plenty of fruits and vegetables Limiting sodium in the diet, thereby reducing blood pressure Exercising regularly Moderating alcohol intake Maintaining a normal weight Controlling blood pressure and keeping blood sugars under control

[edit]Treatment

The mainstay of treatment following acute recovery from a TIA should be to diagnose and treat the underlying cause. It is not always immediately possible to tell the difference between a CVA (stroke) and a TIA. Most patients who are diagnosed at a hospital's emergency department as having suffered from a TIA will be discharged home and advised to contact their primary physician to organize further investigations. A TIA can be considered as the last warning. The reason for the condition should be immediately examined by imaging of the brain. The initial treatment is aspirin, second line is clopidogrel (PLAVIX), third line is ticlopidine. If TIA is recurrent after aspirin treatment, the combination of aspirin and dipyridamole is needed (Aggrenox). An electrocardiogram (ECG) may show atrial fibrillation, a common cause of TIAs, or other arrhythmias that may cause embolisation to the brain. An echocardiogram is useful in detecting thrombus within the heart chambers. Such patients benefit from anticoagulation. If the TIA affects an area supplied by the carotid arteries, an ultrasound (TCD) scan may demonstrate carotid stenosis. For people with a greater than 70% stenosis within the carotid artery, removal of atherosclerotic plaque by surgery, specifically a carotid endarterectomy, may be recommended. The blood vessel is opened up and the plaque is removed. The carotid may be replaced with a vessel retrieved from the lower leg or foot. The procedure is not technically difficult but carries the potential complication of inducing a stroke. A stroke can occur during surgery or after the procedure. The chance of a stroke ranges from 14 percent.[9] Some patients may also be given modified-release dipyridamole or clopidogrel.
[edit]Medication

The use of anti-coagulant medications, heparin and warfarin, or anti-platelet medications such as aspirin may be

warranted. Antiplatelet drugs prevent platelets from agglutinating or sticking to each other, hence the term "blood thinner." Thinning the blood helps to ensure that small particles do not form and travel to the brain. These drugs require frequent monitoring. These drugs also have side effects such as easy bruising and bleeding from mild trauma.[10]
[edit]
Stroke A stroke, previously known medically as a cerebrovascular accident (CVA), is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage (leakage of blood). As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field. A stroke is a medical emergency and can cause permanent neurological damage, complications, and even death. It is the leading cause of adult disability in the United States and Europe and it is the number two cause of death worldwide. Risk factors for stroke include advanced age, hypertension (high blood pressure), previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke. A stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot buster"). Post-stroke prevention may involve the administration of antiplatelet drugs such as aspirin and dipyridamole, control and reduction of hypertension, the use of statins, and in selected patients with carotid endarterectomy, the use of anticoagulants. Treatment to recover any lost function is stroke rehabilitation, involving health professions such as speech and language therapy, physical therapy and occupational therapy. Causes of Stroke Blockage of an artery The blockage of an artery in the brain by a clot (thrombosis) is the most common cause of a stroke. The part of the brain that is supplied by the clotted blood vessel is then deprived of blood and oxygen. As a result of the deprived blood and oxygen, the cells of that part of the brain die and the part of the body that it controls stops working. Typically, a cholesterol plaque in a small blood vessel within the brain that has gradually caused blood vessel narrowing ruptures and starts the process of forming a small blood clot. Risk factors for narrowed blood vessels in the brain are the same as those that cause narrowing blood vessels in the heart and heart attack (myocardial infarction). These risk factors include : high blood pressure (hypertension), high cholesterol, diabetes, and smoking. Embolic stroke Another type of stroke may occur when a blood clot or a piece of atherosclerotic plaque (cholesterol and calcium deposits on the wall of the inside of the heart or artery) breaks loose, travels through the bloodstream and lodges in an artery in the brain. When blood flow stops, brain cells do not receive the oxygen and glucose they require to function and a stroke occurs. This type of stroke is referred to as an embolic stroke. For example, a blood clot might originally form in the heart chamber as a result of an irregular heart rhythm, such as occurs in atrial fibrillation. Usually, these clots remain attached to the inner lining of the heart, but occasionally they can break off, travel through the blood stream, form a plug

(embolism) in a brain artery, and cause a stroke. An embolism can also originate in a large artery (for example, the carotid artery, a major artery in the neck that supplies blood to the brain) and then travel downstream to clog a small artery within the brain. Cerebral hemorrhage A cerebral hemorrhage occurs when a blood vessel in the brain ruptures and bleeds into the surrounding brain tissue. A cerebral hemorrhage (bleeding in the brain) causes stroke symptoms by depriving blood and oxygen to parts of the brain in a variety of ways. Blood flow is lost to some cells. As well, blood is very irritating and can cause swelling of brain tissue (cerebral edema). Edema and the accumulation of blood from a cerebral hemorrhage increases pressure within the skull and causes further damage by squeezing the brain against the bony skull further decreasing blood flow to brain tissue and cells. Subarachnoid hemorrhage In a subarachnoid hemorrhage, blood accumulates in the space beneath the arachnoid membrane that lines the brain. The blood originates from an abnormal blood vessel that leaks or ruptures. Often this is from an aneurysm (an abnormal ballooning out of the wall of the vessel). Subarachnoid hemorrhages usually cause a sudden, severe headache, nausea, vomiting, light intolerance, and a stiff neck. If not recognized and treated, major neurological consequences, such as coma, and brain death may occur. Vasculitis Another rare cause of stroke is vasculitis, a condition in which the blood vessels become inflamed causing decreased blood flow to brain tissue. Migraine headache There appears to be a very slight increased occurrence of stroke in people with migraine headache. The mechanism for migraine or vascular headaches includes narrowing of the brain blood vessels. Some migraine headache episodes can even mimic stroke with loss of function of one side of the body or vision or speech problems. Usually, the symptoms resolve as the headache resolves. Treatment of a Stroke Tissue plasminogen activator (TPA) There is opportunity to use alteplase (TPA) as a clot-buster drug to dissolve the blood clot that is causing the stroke. There is a narrow window of opportunity to use this drug. The earlier that it is given, the better the result and the less potential for the complication of bleeding into the brain. Present American Heart Association guidelines recommend that if used, TPA must be given within 4 1/2 hours after the onset of symptoms. for patients who waken from sleep with symptoms of stroke, the clock starts when they were last seen in a normal state. TPA is injected into a vein in the arm but, the time frame for its use may be extended to six hours if it is dripped directly into the blood vessel that is blocked requiring angiography, which is performed by an interventional radiologist. Not all hospitals have access to this technology. TPA may reverse stroke symptoms in more than one-third of patients, but may also cause bleeding in 6% patients, potentially making the stroke worse. For posterior circulation strokes that involve the vertebrobasilar system, the time frame for treatment with TPA may be extended even further to 18 hours. Heparin and aspirin Drugs to thin the blood (anticoagulation; for example, heparin) are also sometimes used in treating stroke patients in the hopes of improving the patient's recovery. It is unclear, however, whether the use of anticoagulation improves the outcome from the current stroke or simply helps to prevent subsequent strokes (see below). In certain patients, aspirin given after the onset of a stroke does have a small, but measurable

effect on recovery. The treating doctor will determine the medications to be used based upon a patient's specific needs. Managing other Medical Problems Blood pressure will be tightly controlled often using intravenous medication to prevent stroke symptoms from progressing. This is true whether the stroke is ischemic or hemorrhagic. Supplemental oxygen is often provided. In patients with diabetes, the blood sugar (glucose) level is often elevated after a stroke. Controlling the glucose level in these patients may minimize the size of a stroke. Patients who have suffered a transient ischemic attacks, the patient may be discharged with blood pressure and cholesterol medications even if theblood pressure and cholesterol levels are within acceptable levels. Smoking cessation is mandatory. Rehabilitation When a patient is no longer acutely ill after a stroke, the health care staff focuses on maximizing the individuals functional abilities. This is most often done in an inpatient rehabilitation hospital or in a special area of a general hospital. Rehabilitation can also take place at a nursing facility. The rehabilitation process can include some or all of the following : 1. speech therapy to relearn talking and swallowing; 2. occupational therapy to regain as much function dexterity in the arms and hands as possible; 3. physical therapy to improve strength and walking; and 4. family education to orient them in caring for their loved one at home and the challenges they will face. The goal is for the patient to resume as many, if not all, of their pre-stroke activities and functions. Since a stroke involves the permanent loss of brain cells, a total return to the patient's pre-stroke status is not necessarily a realistic goal in many cases. However, many stroke patients can return to vibrant independent lives. Depending upon the severity of the stroke, some patients are transferred from the acute care hospital setting to a skilled nursing facility to be monitored and continue physical and occupational therapy. Many times, home health providers can assess the home living situation and make recommendations to ease the transition home. Unfortunately, some stroke patients have such significant nursing needs that they cannot be met by relatives and friends and long-term nursing home care may be required. (medicinenet.com) Nursing Diagnosis for Stroke 1. Ineffective Airway Clearance 2. Ineffective Cerebral Tissue Perfusion 3. Impaired Physical Mobility 4. Impaired Verbal Communication 5. Disturbed Sensory Perception 6. Imbalanced Nutrition Less Than Body Requirements 7. Self-Care Deficit 8. Risk of Injury 9. Deficient Knowledge

10. Disturbed Sleep Pattern

http://nanda-nursing.blogspot.com/2010/10/nursing-care-plan-for-stroke.html
Nursing Diagnosis for Stroke 1. Impaired brain tissue perfusion related to intracerebral hemorrhage. (Marilynn E. Doenges, 2000) 2. Impaired physical mobility related to hemiparese / hemiplegia (Donna D. Ignativicius, 1995) 3. Impaired sensory perception related to sensory impairment, vision impairment (Donna D. Ignativicius, 1995) 4. Impaired verbal communication related to the decrease in brain blood circulation (Donna D. Ignativicius, 1995) 5. Impaired elimination (constipation) related to immobilization, inadequate fluid intake (Donna D. Ignativicius, 1995) 6. The risk of nutritional deficiencies related to muscle weakness of chewing and swallowing (Barbara Engram, 1998) 7. Lack of compliance with self care related to hemiparese / hemiplegi (Donna D. Ignativicius, 1995) 8. The risk of disruption of skin integrity related long bed rest (Barbara Engram, 1998) 9. The risk of ineffective airway clearance related to the decrease in cough reflex and swallowing. (Juall Lynda Carpenito, 1998) 10. Impaired elimination urine (urine incontinence) related to lesions in the upper motor neuron (Juall Lynda Carpenito, 1998)

Stroke is a life-threatening condition that occurs when the blood supply to a part of the brain is suddenly cut off or when brain tissue is damaged by bleeding into the brain. There are two main types of stroke. Ischemic stroke occurs when a clot formed in the artery or coming from elsewhere in the artery system blocks an artery to the brain; this type accounts for about 80 percent of strokes. The other type, hemorrhagic stroke, occurs when a blood vessel in the brain bursts, allowing blood to spill out into brain tissue. The blood upsets the chemical balance that the nerve cells in the brain need to function. Stroke is usually a sudden occurrence. Some people have a warning event called a transient ischemic attack (TIA) or mini-stroke. A TIA has the same symptoms as a full-blown stroke but goes away in a few minutes or hours, leaving no permanent effects. It is, however, an indication that the person is at risk of a major stroke and should see their doctor right away. A TIA offers the person an opportunity to take preventive action. Stroke has five major signs or symptoms. The American Stroke Association has a quick symptom checklist called Give Me 5 Walk: Is the person having trouble with balance or coordination? Talk: Is speech difficult or slurred? Is the persons face drooping? Reach: Is one side of the body weak or numb? See: Is vision partly or entirely lost? Feel: Does the person have a sudden severe headache with no obvious cause?

A person with stroke can have more than one of these symptoms at the same time. The important feature to keep in mind is that the symptoms come on suddenly, which helps in distinguishing stroke from other causes of dizziness, vision problems, or headache. According to the Centers for Disease Control and Prevention (CDC), stroke is the third leading cause of death in the United States as of 2008, being responsible for about 160,000 deaths each year. About 700,000 Americans have strokes each year, 500,000 for the first time and 200,000 having a second or third stroke. The total cost of stroke to the American economy each year is about $43 billion.

About 50,000 Americans have a TIA in an average year; of this group, 35 percent will have a severe stroke at some point in the future. Strokes can affect people in any age group; however, the risk increases sharply in people over fiftyfive years of age. Seventy-five percent of all strokes occur in people over sixty-four. Men are 1.25 times more likely to have strokes than women; however, women are more likely to die of stroke because they are usually older when they have their first stroke. African Americans have an increased risk of stroke compared to other racial and ethnic groups in the United States, and they are also more likely to suffer a stroke at younger ages. African Americans between the ages of forty-five and fifty-five die from stroke 45 times more often that Caucasians in the same age group. Risk factors for stroke include:

 Hypertension (high blood pressure). This is the most important single risk factor for stroke. High blood cholesterol levels. Being over age fifty-five. A family history of stroke, TIA, or heart attack. Diabetes. Smoking. Smoking doubles a persons risk of ischemic stroke. Personal history of previous stroke or TIA. Obesity. Heavy use of cocaine. Irregular heart rhythm. Heavy drinking. Alcohol consumption raises a persons blood pressure. Use of birth control pills or hormone replacement therapy.
Nursing Care Plan Signs and Symptoms

Stroke is caused by a loss of blood supply to the brain resulting either from a clot blocking an artery or from bleeding into or around the brain. Ischemic stroke can result from two types of clots. The first is an embolus, which is a free-floating clot produced in the heart or somewhere else in the body that travels to a blood vessel in the brain. The second type of clot is formed within an artery in the head or neck and grows there until it is large enough to block the artery. Atherosclerosis, a disease of the blood vessels in which fatty deposits build up along the walls of the vessels, is a common cause of this type of clot. Hemorrhagic stroke can occur when an aneurysma weak spot in the wall of an arterysuddenly bursts. High blood pressure is the most common cause of this type of hemorrhagic stroke. Hemorrhagic stroke can also occur when the walls of an artery become thin and brittle; they can then break and leak blood into the brain. Hemorrhagic stroke can take one of two forms: the blood can leak directly into brain tissue from an artery in the brain, or it can leak from an artery near the surface of the brain into the space between the skull and the membranes covering the brain. The major symptoms of stroke have already been described. Other symptoms that some patients experience include drooling, uncontrollable eye movements, personality or mood changes, drowsiness,loss of memory, or loss of consciousness.
Nursing Care Plan Diagnosis

The diagnosis of stroke includes taking the patients history and obtaining an account of the patients symptoms, followed by a complete physical and a neurological examination to rule out the possibility that the patients symptoms are being caused by a brain tumor. The neurologist may use the National Institutes of Health Stroke Scale (NIHSS), which is a checklist that allows the doctor to record the patients level of consciousness; visual function; ability to move; ability to feel sensations; ability to move the facial muscles; and ability to talk. Other tests include: Blood tests. These can reveal the existence of blood disorders that increase a persons risk of stroke. Computed tomography (CT) scan. This type of imaging test is one of the first tests given to a patient suspected of having a stroke. It helps the doctor determine the cause of the stroke and the extent of brain injury. Magnetic resonance imaging (MRI). This imaging test is useful in pinpointing the location of small or deep brain injuries. Electroencephalogram (EEG). This test measures the brains electrical activity. Blood flow tests. These are done to detect the location and size of any blockages in the blood vessels. One type of blood flow test uses ultrasound to produce an image of the arteries in the neck leading into the brain. Another type of blood flow test, called angiography, uses a special dye injected into blood vessels that will show up on an x ray. Echocardiography. This type of test uses ultrasound to produce an image of the heart. It can be useful in determining whether an embolus from the heart caused the patients stroke.
Nursing Care Plan Treatment

Treatment of stroke depends on whether it is ischemic or hemorrhagic. Ischemic stroke is treated first with blood thinners, often aspirin or another drug known as warfarin. If the patient is seen by a specialized stroke team within three hours of the attack, he or she may be treated with a drug called tissue plasminogen activator or tPA. It is critical, however, to be sure that the patient has an ischemic rather than a hemorrhagic stroke, as blood-thinning drugs can make a hemorrhagic stroke worse. Hemorrhagic stroke is treated by removing pooled blood from the brain and repairing damaged blood vessels. To prevent another hemorrhagic stroke, the surgeon may use a procedure called aneurysm clipping. In this procedure, the surgeon clamps the weak

spot in the artery away from the rest of theblood vessel, which reduces the chances that it will burst and bleed. After emergency treatment in the hospital, most stroke patients need long-term recovery and rehabilitation. The type and length of therapy depend on the amount of function the patient has lost; some need to relearn language skills, while others may need to relearn bowel and bladder control, swallowing, and movement or balance. Most patients need a combination of physical therapy, occupational therapy, speech therapy, and psychotherapy. It is common for stroke patients to feel depressed during rehabilitation or to have trouble controlling their feelings. Prognosis The prognosis of stroke depends on the persons age, the type and location of the stroke, and the amount of time elapsed between diagnosis and treatment. In general, patients with ischemic stroke have a better prognosis than those with hemorrhagic stroke. In one study in the Boston area, 19 percent of patients with ischemic stroke died within the first thirty days of the attack compared to 35 percent with hemorrhagic stroke. About 10 percent of stroke patients recover enough function to live independently without help; another 50 percent can remain at home with outside assistance. The remaining 40 percent require long-term care in a nursing home.
Nursing Care Plan Prevention

People cannot change some risk factors for stroke, such as race, age, sex, or family history, but they can control several other risk factors: They can quit smoking, drinking heavily, or using cocaine. They can keep their weight at a healthy level. They can exercise regularly, eat a healthy diet, and take medications for high blood pressure if they are diagnosed with it. They can take steps to lower their risk of diabetes or high blood cholesterol levels. They can lower the level of emotional stress in their life or learn to manage stress more effectively. They can get regular checkups for abnormal heart rhythms if they have been diagnosed with such problems. They can see their doctor at once if they have a TIA. http://www.enurse-careplan.com/2010/10/nursing-care-plan-ncp-stroke.html

Causes
A TIA is different than a stroke. After a TIA, the blockage breaks up quickly and dissolves. Unlike a stroke, a TIA does not cause brain tissue to die. The loss of blood flow to an area of the brain can be caused by:

A blood clot in an artery of the brain A blood clot that travels to the brain from somewhere else in the body (for example, from the heart) An injury to blood vessels Narrowing of a blood vessel in the brain or leading to the brain

High blood pressure is the number one risk for TIAs and stroke. The other major risk factors are:

Atrial fibrillation Diabetes Family history of stroke High cholesterol Increasing age, especially after age 55 Race (African Americans are more likely to die from stroke)

People who have heart disease or poor blood flow in their legs caused by narrowed arteries are also more likely to have a TIA or stroke. See also: Stroke risk factors
Back to TopSymptoms

Symptoms begin suddenly, last only a short time (from a few minutes to 1 - 2 hours), and go away completely. They may occur again at a later time. The symptoms of TIA are the same as the symptoms of a stroke, and include sudden:

Abnormal feeling of movement (vertigo) or dizziness Change in alertness (sleepiness, less responsive, unconscious, or in a coma) Changes in feeling, including touch, pain, temperature, pressure, hearing, and taste Confusion or loss of memory Difficulty swallowing Difficulty writing or reading Drooping of the face Inability to recognize objects or people Lack of control over the bladder or bowels Lack of coordination and balance, clumsiness, or trouble walking Loss of vision in one or both eyes Numbness or tingling on one side of the body Personality, mood, or emotional changes Trouble saying or understanding words

Weakness on one side of the body

In-Depth Symptoms
Back to TopExams

and Tests

Almost always, the symptoms and signs of a TIA will have gone away by the time you get to the hospital. A TIA diagnosis may be made based on your medical history alone. The health care provider will do a complete physical exam to check for heart and blood vessel problems, as well as for problems with nerves and muscles. Your blood pressure may be high. The doctor will use a stethoscope to listen to your heart and arteries. An abnormal sound called a bruit may be heard when listening to the carotid artery in the neck or other artery. A bruit is caused by irregular blood flow. Tests will be done to rule out a stroke or other disorders that may cause the symptoms.

You will almost always have a head CT scan or brain MRI. A stroke will show changes on these tests, but TIAs will not. You will have an angiogram, CT angiogram, or MR angiogram to see which blood vessel is blocked or bleeding. You may have an echocardiogram if your doctor thinks you may have a blood clot from the heart. Carotid duplex (ultrasound) can show if the carotid arteries in your neck have narrowed. You may have an EKG and heart rhythm monitoring tests to check for an irregular heartbeat.

Your doctor may do other tests to check high blood pressure, heart disease, diabetes, high cholesterol, and other causes of, and risk factors for TIAs or stroke.
In-Depth Diagnosis
Back to TopTreatment

The goal is to prevent a stroke. If you have had a TIA within the last 48 hours, you will likely be admitted to the hospital so that doctors can search for the cause and observe you. High blood pressure, heart disease, diabetes, and blood disorders should be treated as needed. You may receive blood thinners, such as aspirin, to reduce blood clotting. Other options include dipyridamole, clopidogrel, Aggrenox or heparin, Coumadin, or similar medicines. You may be treated for a long period of time. Some people who have clogged neck arteries may need surgery (carotid endarterectomy). If you have irregular heartbeats (atrial fibrillation), you will be treated to avoid future complications.
In-Depth Treatment