Definition and evaluation of transient ischemic attack: A scientific statement for healthcare professionals from the American heart association/American stroke association stroke council; council on cardiovascular surgery and anesthesia; council on cardiovascular radiology and intervention; council on cardiovascular nursing; and the interdisciplinary council on peripheral vascular disease

J. Donald Easton, Jeffrey L. Saver, Gregory W. Albers, Mark J. Alberts, Seemant Chaturvedi, Edward Feldmann, Thomas S. Hatsukami, Randall T. Higashida, S. Claiborne Johnston, Chelsea S. Kidwell, Helmi L. Lutsep, Elaine Miller, Ralph L. Sacco

Research output: Contribution to journalReview article

1044 Scopus citations

Abstract

This scientific statement is intended for use by physicians and allied health personnel caring for patients with transient ischemic attacks. Formal evidence review included a structured literature search of Medline from 1990 to June 2007 and data synthesis employing evidence tables, meta-analyses, and pooled analysis of individual patient-level data. The review supported endorsement of the following, tissue-based definition of transient ischemic attack (TIA): a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction. Patients with TIAs are at high risk of early stroke, and their risk may be stratified by clinical scale, vessel imaging, and diffusion magnetic resonance imaging. Diagnostic recommendations include: TIA patients should undergo neuroimaging evaluation within 24 hours of symptom onset, preferably with magnetic resonance imaging, including diffusion sequences; noninvasive imaging of the cervical vessels should be performed and noninvasive imaging of intracranial vessels is reasonable; electrocardiography should occur as soon as possible after TIA and prolonged cardiac monitoring and echocardiography are reasonable in patients in whom the vascular etiology is not yet identified; routine blood tests are reasonable; and it is reasonable to hospitalize patients with TIA if they present within 72 hours and have an ABCD score = 3, indicating high risk of early recurrence, or the evaluation cannot be rapidly completed on an outpatient basis.

Original languageEnglish (US)
Pages (from-to)2276-2293
Number of pages18
JournalStroke
Volume40
Issue number6
DOIs
StatePublished - Jun 1 2009
Externally publishedYes

Keywords

  • Acute cerebrovascular syndromes
  • Acute stroke syndromes
  • AHA scientific statements
  • Brain
  • Brain ischemia
  • Cerebral ischemia
  • Ischemia
  • Stroke
  • Transient ischemic attack

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Medicine(all)

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