Atransient ischaemic attack (TIA) is defined as an acute neurological event causing loss of focal cerebral or ocular function lasting less than 24 hours and thought to be due to inadequate cerebral or ocular blood supply. More than 46 000 people suffer a TIA in the UK each year. Of these, approximately 10% will go on to suffer a stroke within the next 5 days and 20% within the next 4 weeks. The importance of this diagnosis both to the individual and to the National Health Service (NHS) is therefore huge. This article will discuss the diagnosis and management of TIA in general practice including primary and secondary preventative strategies.
CoullA.LovettJ.K.RothwellP.M., On behalf of the Oxford Vascular Study. Early risk of stroke after a TIA or minor stroke in a population-based incidence study. British Medical Journal (2004) 328: p. 326–8
DVLA. At a glance guide to the current medical standards of fitness to drive. (2011) Accessed via www.dft.gov.uk/dvla/medical/ataglance.aspx [Date last accessed 14.04.2011]
6.
European Carotid Surgery Trialists' Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet (1998) 351 p. 1379–87
7.
GilesM.F.RothwellP.M.Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurology (2007) 6(12): p. 1063–72
JohnstonS.C.GressD.R.BrownerW.S.Short-term prognosis after emergency department diagnosis of TIA. Journal of the American Medical Association (2000) 284: p. 2901–6
10.
JohnstonS.C.RothwellP.M.Nguyen-HuynhM.N.Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet (2007) 369: p. 283–92
11.
NICE. Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease (2008) Accessed via www.guidance.nice.org.uk/CG67/Guidance/pdf/English [Date last accessed 26.3.2011]
NICE. Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events (TA210) (2010) Accessed via www.nice.org.uk/nicemedia/live/13285/52030/52030.pdf [Date last accessed 17.1.2011]
RothwellP.M.Transient ischaemic attacks: time to wake up. Heart (2007) 93: p. 893–894
17.
RothwellP.M.EliasziwM.GutnikovS.A.Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet (2003) 361: p. 107–116
18.
RothwellP.M.EliasziwM.GutnikovS.A.Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet (2004) 363: p. 915–924
19.
RothwellP.M.GilesM.F.ChandrathevaA.Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet (2007) 370(9596): p. 1432–1442
20.
RothwellP.M.WarlowC.P.Timing of TIAs preceding stroke: time window for prevention is very short. Neurology (2005) 64: p. 817–820
21.
The North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. New England Journal of Medicine (1991) 325: p. 445–453
