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Differential Diagnosis: TRANSIENT ISCHEMIC ATTACK

Pathophysiology:

TIAs are episodes of stroke symptoms that last only briefly, <24 h, but most TIAs last <1h. TIAs may
arise from emboli to the brain or from in situ thrombosis of an intracranial vessel.

Acute occlusion of an intracranial vessel causes reduction in blood flow to brain region it supplies. A fall
in cerebral blood flow to zero causes death of brain tissue within 4-10 min. If blood flow is restored prior
to a significant amount of cell death, the patient may experience only transient symptoms.

TIAs are often warning signs of a future stroke. The risk of a stroke increases dramatically in the days
after a transient ischemic attack, and the TIA may offer an opportunity to find a cause or minimize the
risk to prevent the permanent neurologic damage that results because of a stroke.


































Arterial Occlusion

Ischemia
Energy failure
Ca2+/Na+ influx
Proteolysis
Membrane and cytoskeletal
breakdown
Cell death














Mitochondrial
damage
Apoptosis
Patients S/S Features
Weakness of right hand grip Slurring of speech-paralysis of tongue
HPN Paralysis of face
Old Age Temporary loss of vision
Family history of CVA Aphasia
Hemiparesis
Paresthesia
Risk factors- HPN,tobacco smoking, DM,old age




Ancillary procedures:
CBC & ESR
RBS/FBS
ECG & 2D Echo
Cranial CT-Scan
Diffusion Weighted MRI

Treatment:
Aspirin 50-325mg/day
Clopidogrel 75mg/day