Coutts Shelagh B
Continuum (Minneap Minn). 2017 Feb;23(1, Cerebrovascular Disease):82-92. doi: 10.1212/CON.0000000000000424.
This article reviews the diagnosis, investigation, and recommended management after a transient ischemic attack (TIA) and discusses how to make an accurate diagnosis, including the diagnosis of mimics of TIAs.
Up to a 10% risk of recurrent stroke exists after a TIA, and up to 80% of this risk is preventable with urgent assessment and treatment. Imaging of the brain and intracranial and extracranial blood vessels using CT, CT angiography, carotid Doppler ultrasound, and MRI is an important part of the diagnostic assessment. Treatment options include anticoagulation for atrial fibrillation, carotid revascularization for symptomatic carotid artery stenosis, antiplatelet therapy, and vascular risk factor reduction strategies.
TIA offers the greatest opportunity to prevent stroke that physicians encounter. A TIA should be treated as a medical emergency, as up to 80% of strokes after TIA are preventable.
本文回顾了短暂性脑缺血发作（TIA）后的诊断、检查及推荐的管理方法，并讨论如何进行准确诊断，包括TIA模仿者的诊断。
TIA后存在高达10%的复发性中风风险，其中高达80%的风险可通过紧急评估和治疗预防。使用CT、CT血管造影、颈动脉多普勒超声和MRI对脑及颅内和颅外血管进行成像，是诊断评估的重要组成部分。治疗选择包括针对心房颤动的抗凝治疗、针对有症状颈动脉狭窄的颈动脉血运重建、抗血小板治疗以及血管危险因素降低策略。
TIA为医生预防中风提供了最大的机会。TIA应被视为医疗急症，因为TIA后高达80%的中风是可预防的。
