TIA as Acute Cerebrovascular Syndrome

Editor(s): Uchiyama, S. (Tokyo)
Amarenco, P. (Paris)
Minematsu, K. (Osaka)
Wong, K.S.L. (Hong Kong)
 

Transient Ischemic Attack as a Medical Emergency

Okada Y.

Author affiliations

Department of Cerebrovascular Medicine and Neurology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

Related Articles for ""
Uchiyama S, Amarenco P, Minematsu K, Wong KSL (eds): TIA as Acute Cerebrovascular Syndrome. Front Neurol Neurosci. Basel, Karger, 2014, vol 33, pp 19-29
https://doi.org/10.1159/000351889

Log in to MyKarger to check if you already have access to this content.




Forgot your password
Sign up to MyKarger

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more
CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!


If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00

Select

Complete book

  • Immediate access to all parts of this book
  • Cover-to-cover formats may be available
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restriction for personal use
read more

Pricing depends on hard-cover price

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

Published online: October 11, 2013
Cover Date: 2014

Number of Print Pages: 11
Number of Figures: 4
Number of Tables: 1

ISBN: 978-3-318-02458-6 (Print)
eISBN: 978-3-318-02459-3 (Online)

Abstract

Since transient ischemic attack (TIA) is regarded as a medical emergency with high risk for early stroke recurrence, the underlying mechanisms should be immediately clarified to conclude a definitive diagnosis and provide early treatment. Early risk stratification using ABCD2 scores can predict the risk of ischemic stroke occurring after TIA. Carotid ultrasonography (US) can evaluate the degree of stenosis, plaque properties and flow velocity of ICA lesions. High-risk mobile plaques can be classified by carotid US, and aortogenic sources of emboli can be detected by transesophageal echocardiography. Cardiac monitoring and blood findings are thought to play a key role in a diagnosis of cardioembolic TIA. Diffusion-weighted imaging (DWI)-MRI and MR angiography are also indispensable to understand the mechanism of TIA and cerebral circulation. To prevent subsequent stroke arising from TIA, antiplatelet and anticoagulant therapies should be started immediately along with comprehensive management of life-style, hypertension, diabetes mellitus, dyslipidemia and other atherosclerotic diseases. Carotid endarterectomy and endovascular intervention are critical for treating symptomatic patients with significant stenosis of ICA. A novel concept of acute cerebrovascular syndrome (ACVS) has recently been advocated to increase awareness of TIA among citizens, patients and medical professionals. TIA should be recognized as the last opportunity to avoid irreversible ischemic stroke and its sequelae. The clinical relevance of the new concept of ACVS is advocated by early recurrence after TIA, analysis of high-risk TIA, treatment strategies and the optimal management of TIA. Raising TIA awareness should also proceed across many population sectors.

© 2014 S. Karger AG, Basel

References

  1. Wu CM, McLaughlin K, Lorenzetti DL, Hill MD, Manns BJ, Ghali WA: Early risk of stroke after transient ischemic attack: a systematic review and meta-analysis. Arch Intern Med 2007;167:2417-2422.
    External Resources
  2. Lisabeth LD, Ireland JK, Risser JM, Brown DL, Smith MA, Garcia NM, et al: Stroke risk after transient ischemic attack in a population-based setting. Stroke 2004;35:1842-1846.
    External Resources
  3. Chandratheva A, Mehta Z, Geraghty OC, Marquardt L, Rothwell PM: Population-based study of risk and predictors of stroke in the first few hours after a TIA. Neurology 2009;72:1941-1947.
    External Resources
  4. Johnston SC, Gress DR, Browner WS, Sidney S: Short-term prognosis after emergency department diagnosis of TIA. JAMA 2000;284:2901-2906.
    External Resources
  5. Mori M, Okada Y, Yoshimura S, Matsushita T, Miyazaki Y, Makihara N, Wakugawa Y, Yasaka M: ABCD2 score to identify individuals on admission at high early risk of stroke after transient ischemic attack. Jpn J Stroke 2011;33:25-30.
  6. Weimar C, Kraywinkel K, Rödl J, Hippe A, Harms L, Kloth A, Diener HC; German Stroke Data Bank Collaborators: Etiology, duration, and prognosis of transient ischemic attacks: an analysis from the German Stroke Data Bank. Arch Neurol 2002;59:1584-1588.
    External Resources
  7. Rothwell PM, Giles MF, Chandratheva A, Marquardt L, Geraghty O, Redgrave JN, et al: Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet 2007;370:1432-1442.
    External Resources
  8. Luengo-Fernandez R, Gray AM, Rothwell PM: Effect of urgent treatment for transient ischaemic attack and minor stroke on disability and hospital costs (EXPRESS study): a prospective population-based sequential comparison. Lancet Neurol 2009;8:235-243.
    External Resources
  9. Lavallée PC, Meseguer E, Abboud H, Cabrejo L, Olivot JM, Simon O, et al: A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurol 2007;6:953-960.
    External Resources
  10. Shinohara Y, Yanagihara T, Abe K, Yoshimine T, Fujinaka T, Chuma T, Ochi F, Nagayama M, Ogawa A, Suzuki N, Katayama Y, Kimura A, Minematsu K: II. Cerebral infarction/transient ischemic attack (TIA). J Stroke Cerebrovasc Dis 2011;20(suppl 1):S31-S73.
    External Resources
  11. Uchiyama S, Johnston SC, Okada Y: New concepts of treatment for TIA as a medical emergency (round table discussion). Int Rev Thromb 2009;4:5-21.
  12. Guedes LC, Ferro JM: A systematic review of immediate anticoagulation for ischemic stroke of presumed cardioembolic origin. Stroke 2008;39:e81-e82.
    External Resources
  13. Paciaroni M, Agnelli G, Micheli S, Caso V: Efficacy and safety of anticoagulant treatment in acute cardioembolic stroke: a meta-analysis of randomized controlled trials. Stroke 2007;38:423-430.
    External Resources
  14. Eliasziw M, Kennedy J, Hill MD, Buchan AM, Barnett HJM, The North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group: Early risk of stroke after a transient ischemic attack in patients with internal carotid artery disease. CMAJ 2004;170:1105-1109.
    External Resources
  15. Bond R, Rerkasem K, Rothwell PM: Systematic review of the risks of carotid endarterectomy in relation to the clinical indication for and timing of surgery. Stroke 2003;34:2290-2301.
    External Resources
  16. Johnston SC, Rothwell PM, Nguyen-Huynh MN, Giles MF, Elkins JS, Bernstein AL, et al: Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 2007;369:283-292.
    External Resources
  17. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, Whetstone WD, Josephson SA, Johnston SC, Kim AS: Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. Stroke 2012;43:1484-1489.
    External Resources
  18. Purroy F, Montaner J, Rovira A, Delgado P, Quintana M, Alvarez-Sabin J: Higher risk of further vascular events among transient ischemic attack patients with diffusion-weighted imaging acute ischemic lesions. Stroke 2004;35:2313-2319.
    External Resources
  19. Calvet D, Touze E, Oppenheim C, Turc G, Meder JF, Mas JL: DWI lesions and TIA etiology improve the prediction of stroke after TIA. Stroke 2009;40:187-192.
    External Resources
  20. Nolte CH, Albach FN, Heuschmann PU, Brunecker P, Villringer K, Endres M, Fiebach JB: Silent new DWI lesions within the first week after stroke. Cerebrovasc Dis 2012;33:248-254.
    External Resources
  21. Giles MF, Albers GW, Amarenco P, Arsava EM, Asimos AW, Ay H, Calvet D, Coutts SB, Cucchiara BL, Demchuk AM, Johnston SC, Kelly PJ, Kim AS, Labreuche J, Lavallee PC, Mas J-L, Merwick A, Olivot JM, Purroy F, Rosamond WD, Sciolla R, Rothwell PM: Early stroke risk and ABCD2 score performance in tissue- vs time-defined TIA. A multicenter study. Neurology 2011;77:1222-1228.
    External Resources
  22. Ogata T, Yasaka M, Wakugawa Y, Kitazono T, Okada Y: Morphological classification of mobile plaques and their association with early recurrence of stroke. Cerebrovasc Dis 2010;30:606-611.
    External Resources
  23. Flint AC, Banki NM, Ren X, Rao VA, Go AS: Detection of paroxysmal atrial fibrillation by 30-day event monitoring in cryptogenic ischemic stroke: the Stroke and Monitoring for PAF in Real Time (SMART) Registry. Stroke 2012;43:2788-2790.
    External Resources
  24. Inoue T, Kimura K, Minematsu K, Yamaguchi T, Japan Multicenter Stroke Investigators' Collaboration (J-MUSIC: Clinical features of transient ischemic attack associated with atrial fibrillation: analysis of 1084 TIA patients. J Stroke Cerebrovasc Dis 2004;13:155-159.
    External Resources
  25. Coull AJ, Lovett JK, Rothwell PM; Oxford Vascular Study: Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. BMJ 2004;328:326-328.
    External Resources
  26. Kleindorfer D, Lindsell CJ, Moomaw CJ, Alwell K, Woo D, Flaherty ML, Adeoye O, Zakaria T, Broderick JP, Kissela BM: Which stroke symptoms prompt a 911 call? A population-based study. Am J Emerg Med 2010;28:607-612.
    External Resources
  27. Mori M, Okada Y, Yoshimura S, Matsushita T, Miyazaki Y, Makihara N, Wakugawa Y, Yasaka M: ABCD2 score to identify individuals on admission at high early risk of stroke after transient ischemic attack. Jpn J Stroke 2011;33:25-30.

Article / Publication Details

Published online: October 11, 2013
Cover Date: 2014

Number of Print Pages: 11
Number of Figures: 4
Number of Tables: 1

ISBN: 978-3-318-02458-6 (Print)
eISBN: 978-3-318-02459-3 (Online)

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.

Article Tools
Article Details

Table of Contents

Article

TAP Icon This Article is Part of
Recommend This
TOP