Symptoms of a transient ischaemic attack (TIA/mini stroke) are similar to a stroke, but they disappear within 24 hours. TIA indicates a greater risk of stroke in the near future. Therefore, TIA should be managed as a medical emergency.
TIA patients should be assessed using ABCD2 scale as soon as possible because it indicates the risk of stroke. If the patient has ABCD2 score of six or seven, risk of stroke within two days is 8.1 %. If someone has more than one episode of TIA during the previous week, they have a 30 % greater risk of developing a major stroke within one week.
TIA patients, who have a high risk of stroke, should be offered the treatment with Aspirin daily and assessed by a specialist within 24 hours. If it is difficult to define the territory of the brain, which has been affected, the specialist may decide to do a brain scan (CT scan or MRI scan) within 24 hours.
TIA patients with a lower risk of stroke should be treated with Aspirin and should be assessed by a specialist within a week. If the specialist cannot define the affected area of the brain, he or she will decide to do a brain scan within a week.
The healthcare team will advise about drugs and lifestyle changes because those will help the patient reduce the risk of stroke in the future.
If the TIA patient has features of the carotid artery (a major artery, which is in the neck, supplies blood to the brain) narrowing, a carotid artery duplex scan should be done ideally within a week.
If the carotid artery duplex scan indicates a significant blockage of the carotid artery, a carotid endarterectomy (an operation) should be done to relieve the narrowing. This operation should be done ideally within two weeks of TIA.
All patients, who are with a carotid artery narrowing should receive anti-platelet medications to cut blood clotting. The healthcare team will advise them about controlling blood pressure and cholesterol.
(Photo courtesy: Akira Ohgaki)