Madden Joshua, Kahn D Ethan
Department of Emergency, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Division of Neurocritical Care, Department of Neurology, NYU Langone Health, Brooklyn, NY, USA.
Emerg Med Clin North Am. 2026 Feb;44(1):71-83. doi: 10.1016/j.emc.2025.08.005. Epub 2025 Oct 13.
A transient ischemic attack is an acute neurologic event caused by focal ischemia affecting the brain, eye, or spinal cord, resolving quickly without infarction on magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI). It is a tissue-based diagnosis, highlighting the need for prompt recognition and risk stratification. Evaluation in the emergency department includes detailed history, risk assessment, neurologic examination, and initial noncontrast computed tomography (CT) to rule out other conditions, with MRI DWI as the gold standard for confirming no infarction. Vascular imaging, echocardiography, electrocardiogram (ECG), and laboratories help identify underlying causes. Central retinal artery occlusion (CRAO) requires urgent diagnosis and ophthalmology consultation to prevent permanent vision loss.
短暂性脑缺血发作是一种急性神经事件，由影响大脑、眼睛或脊髓的局灶性缺血引起，在磁共振成像（MRI）弥散加权成像（DWI）上无梗死且迅速缓解。这是一种基于组织的诊断，凸显了及时识别和风险分层的必要性。在急诊科的评估包括详细病史、风险评估、神经系统检查以及初始非增强计算机断层扫描（CT）以排除其他疾病，MRI DWI作为确认无梗死的金标准。血管成像、超声心动图、心电图（ECG）和实验室检查有助于识别潜在病因。视网膜中央动脉阻塞（CRAO）需要紧急诊断并咨询眼科以防止永久性视力丧失。
