Common issues arising in the management of patients with TIA and stroke and the application of best evidence practice in managing and preventing these conditions are highlighted in this case-based article.
- A transient ischaemic attack (TIA) is a transient neurovascular event that resolves within 24 hours without acute infarction on MRI.
- Rapid assessment and treatment of TIAs can prevent disabling strokes in up to 80% of cases.
- Urgent investigations for TIA or stroke should include: imaging of the brain; imaging of the carotid and vertebral arteries; 12-channel ECG and Holter monitoring; transthoracic echocardiography; and blood pressure, fasting lipids and glucose measurements.
- The American Heart Association (AHA)/American Stroke Association (ASA) have recently updated their guidelines on primary and secondary stroke prevention, focusing on lifestyle modification and management of hypertension, hyperlipidaemia and diabetes.
- The targets for primary prevention are less strict than for secondary prevention, but the same principles for treatment and lifestyle changes apply.
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