Clinical features and differential diagnosis of a transient ischemic attack

2009 ◽  
pp. 101-112
Author(s):  
Sarah T. Pendlebury ◽  
Matthew F. Giles ◽  
Peter M. Rothwell
Keyword(s):  
Differential Diagnosis ◽  
Clinical Features ◽  
Transient Ischemic Attack ◽  
Ischemic Attack

Transient Ischemic Attack: Clinical Features and Outcome

2017 ◽  
Vol 10 (1) ◽  
pp. 25-28
Author(s):  
Desislava D. Drenska ◽  
Dimitar B. Maslarov
Keyword(s):  
Clinical Features ◽  
Transient Ischemic Attack ◽  
Social Significance ◽  
State Of Emergency ◽  
Pathogenetic Mechanisms ◽  
The Social ◽  
Significant Difference ◽  
Neurology Clinic ◽  
Prognostic Outcome ◽  
Ischemic Attack

SummaryA Transient Ischemic Attack (TIA) is a state of emergency and an independent risk factor for ischemic stroke. The social significance of the disease is determined, based on the probability of occurrence of subsequent cerebrovascular incidents and their frequency among groups. The purpose of the present study was to perform a comparative analysis of clinical features and outcome in patients with TIA for at least 24 months after onset had been registered, according to the pathogenesis and to ABCD (2) score. Two hundred and fifty-seven patients were monitored at the Neurology Clinic, First MHAT – Sofia after suffering an initial TIA. All subjects were studied using a clinical evaluation of pathogenetic mechanisms and an ABCD (2) algorithm. A diagnosis of TIA was confirmed by neuroimaging. The comparison between specific pathogenetic mechanisms demonstrated a statistically significant difference. Two TIA subgroups were involved – thromboembolic and cryptogenic (p<0.05). Also, according to the ABCD (2) score results, significant differences were found between groups at low (1-3) and high (6-7) risk, and those at intermediate (4-5) and high risk (p<0.01). Detailed investigation and assessment of patients with TIA are important concerning the prognostic outcome.

scholarly journals Usefulness of EEG for the differential diagnosis of possible transient ischemic attack

2018 ◽  
Vol 3 ◽  
pp. 11-19 ◽  
Author(s):  
Carla Bentes ◽  
Patrícia Canhão ◽  
Ana Rita Peralta ◽  
Pedro Viana ◽  
Ana Catarina Fonseca ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Transient Ischemic Attack ◽  
Ischemic Attack

Clinical Features and Functional Outcome of Stroke After Transient Ischemic Attack

2013 ◽  
Vol 22 (3) ◽  
pp. 260-266 ◽  
Author(s):  
Takao Hoshino ◽  
Satoko Mizuno ◽  
Satoru Shimizu ◽  
Shinichiro Uchiyama
Keyword(s):  
Functional Outcome ◽  
Clinical Features ◽  
Transient Ischemic Attack ◽  
Ischemic Attack

scholarly journals How do neurologists diagnose transient ischemic attack: A systematic review

2018 ◽  
Vol 14 (2) ◽  
pp. 115-124 ◽  
Author(s):  
Tess Fitzpatrick ◽  
Sophia Gocan ◽  
Chu Q Wang ◽  
Candyce Hamel ◽  
Aline Bourgoin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Features ◽  
Transient Ischemic Attack ◽  
Stroke Prevention ◽  
Negative Symptoms ◽  
Risk Scores ◽  
Cochrane Library ◽  
Transient Ischemic Attacks ◽  
Altered Level ◽  
Ischemic Attack

Background Identifying and treating patients with transient ischemic attack is an effective means of preventing stroke. However, making this diagnosis can be challenging, and over a third of patients referred to stroke prevention clinic are ultimately found to have alternate diagnoses. Aims We performed a systematic review to determine how neurologists diagnose transient ischemic attack. Summary of review A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using MEDLINE, Embase, and the Cochrane Library databases. Publications eligible for inclusion were those that included information on the demographic or clinical features neurologists use to diagnose transient ischemic attacks or transient ischemic attack–mimics. Of 1666 citations, 210 abstracts were selected for full-text screening and 80 publications were ultimately deemed eligible for inclusion. Neurologists were more likely to diagnose transient ischemic attack based on clinical features including negative symptoms or speech deficits. Patients with positive symptoms, altered level of consciousness, or the presence of nonfocal symptoms such as confusion or amnesia were more likely to be diagnosed with transient ischemic attack–mimic. Neurologists commonly include mode of onset (i.e. sudden versus gradual), recurrence of attacks, and localizability of symptoms to a distinct vascular territory in the diagnostic decision-making process. Transient ischemic attack diagnosis was more commonly associated with advanced age, preexisting hypertension, atrial fibrillation, and other vascular risk factors. Conclusions Neurologists rely on certain clinical and demographic features to distinguish transient ischemic attacks from mimics, which are not currently reflected in widely used risk scores. Clarifying how neurologists diagnose transient ischemic attack may help frontline clinicians to better select patients for referral to stroke prevention clinics.

scholarly journals Diagnostic Accuracy of the Explicit Diagnostic Criteria for Transient Ischemic Attack

Stroke ◽  
2019 ◽  
Vol 50 (8) ◽  
pp. 2080-2085 ◽  
Author(s):  
L. Servaas Dolmans ◽  
Elena R. Lebedeva ◽  
Dinusha Veluponnar ◽  
Ewoud J. van Dijk ◽  
Paul J. Nederkoorn ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Diagnostic Criteria ◽  
Clinical Diagnosis ◽  
Clinical Features ◽  
Transient Ischemic Attack ◽  
Predictive Value ◽  
Minor Stroke ◽  
Clinical Tool ◽  
Predictive Values ◽  
Ischemic Attack

Background and Purpose— The clinical diagnosis of a transient ischemic attack (TIA) can be difficult. Evidence-based criteria hardly exist. We evaluated if the recently proposed Explicit Diagnostic Criteria for TIA (EDCT), an easy to perform clinical tool focusing on type, duration, and mode of onset of clinical features, would facilitate the clinical diagnosis of TIA. Methods— We used data from patients suspected of a TIA by a general practitioner and referred to a TIA service in the region of Utrecht, the Netherlands, who participated in the MIND-TIA (Markers in the Diagnosis of TIA) study. Information about the clinical features was collected with a standardized questionnaire within 72 hours after onset. A panel of 3 experienced neurologists ultimately determined the definite diagnosis based on all available diagnostic information including a 6-month follow-up period. Two researchers scored the EDCT. Sensitivity, specificity, and predictive values of the EDCT were assessed using the panel diagnosis as reference. A secondary analysis was performed with modified subcriteria of the EDCT. Results— Of the 206 patients, 126 (61%) had a TIA (n=104) or minor stroke (n=22), and 80 (39%) an alternative diagnosis. Most common alternative diagnoses were migraine with aura (n=24; 30.0%), stress related or somatoform symptoms (n=16; 20.0%), and syncope (n=9; 11.3%). The original EDCT had a sensitivity of 98.4% (95% CI, 94.4–99.8) and a specificity of 61.3% (49.7–71.9). Negative and positive predictive values were 96.1% (86.0–99.0) and 80.0% (75.2–84.1), respectively. The modified EDCT showed a higher specificity of 73.8% (62.7–83.0) with the same sensitivity and a similar negative predictive value of 96.7%, but a higher positive predictive value of 85.5% (80.3–89.5). Conclusions— The EDCT has excellent sensitivity and negative predictive value and could be a valuable diagnostic tool for the diagnosis of TIA.

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