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Review 8: Managing Patients With Transient Ischemic Attack

Reviewers

Angela Hua, MD

Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY; Faculty, Department of Emergency Medicine, Northwell Health at Long Island Jewish Medical Center
New Hyde Park, NY

David Romanelli, DO

Department of Emergency Medicine, Northwell Health at North Shore University Hospital, Manhasset, NY, and Long Island Jewish Medical Center
New Hyde Park, NY

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1. Article Citation
2. Synopsis
3. Critique
4. ABEM Quick Quiz Answers
5. Key Points
6. Original Article

Article Citation

Edlow JA. Managing patients with transient ischemic attack. Ann Emerg Med. 2018;71(3):409-415.

Synopsis

Transient ischemic attack (TIA) is a neurologic emergency with tremendous public health significance, and appropriate risk stratification has important ramifications. A TIA patient often presents without any neurologic deficit, but the incidence of a clinically significant acute ischemic stroke 48 hours later is reportedly as high as 4.8%. Rapidly implementing multiple interventions (“secondary stroke prevention”) can reduce the outcome of stroke by up to 80%. This article reviews the management of neurologically intact patients diagnosed with TIA in the emergency department (ED). Clinical diagnosis, risk stratification, diagnostic testing, treatment, and disposition are also reviewed.

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