The diagnosis of transient ischemic attacks (TIAs) is subject to considerable interobserver variation. One of the reasons may be that the diagnostic guidelines are phrased in abstract diagnostic terms such as amaurosis fugax, which require an interpretation of symptoms. The reliability of the diagnosis of TIA can be improved if the nature and time course of the symptoms are recorded in plain language. Another reason may be the arbitrary upper time limit of 24 h, while most clinical evidence suggests that TIAs and ischemic strokes should be regarded as a continuum rather than as separated subgroups. The overall risk of stroke or death in untreated TIA patients is approximately 10% per year. Recent studies have identified the following specific risk factors: increased age; male gender, multiple attacks; dysarthria; other vascular diseases, including diabetes, claudication, and angina, and the presence of various abnormalities on CT scan or electrocardiography. Patients with monocular visual symptoms only or vertigo as a main symptom have half the risk of patients with hemispheric attacks. The risk of stroke is specifically associated with an elevated hematocrit, and gradually increases with the duration of symptoms, independent of the classical ''boundaries'' at 24 h and 6 weeks which separate TIAs, reversible ischemic neurological deficits and strokes. Patients with symptoms atypical for a TIA may have a low risk of stroke but a high risk of major cardiac events. These findings underscore the need to (1) stratify patients with cerebral ischemia according to the risk of subsequent vascular events, especially in therapeutic trials, and (2) focus on the nature rather than the duration of symptoms.

Keywords:
Transient ischemic attacks, Diagnosis, Prognosis, Atypical TIAs
This content is only available via PDF.
© 1994 S. Karger AG, Basel
1994
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.