Transient Ischemic Attack (TIA) Treatment and Diagnosis
Patients who arrive in the TIA unit with suspected TIA are immediately evaluated by a team of providers. The focus is on differentiating a TIA from stroke or other conditions with symptoms that are the same as or similar to stroke.
We obtain a history of the onset of symptoms, examine the patient, use neuroimaging to examine the brain and its blood vessels, and perform an evaluation of the heart.
The resulting diagnosis allows us to quickly ascertain clinical risk criteria to identify patients at highest and lowest risk of stroke. Those experiencing a TIA are treated immediately with medication, and then monitored for 24 hours in the unit.
TIA Diagnosis, Step by Step
- Physical examination to assess for loss of function in strength, speech or sensation
- Comprehensive history to assess for risk factors indicative of elevated risk for stroke after a TIA, such as advanced age, diabetes, hypertension, carotid stenosis and prior TIA or stroke
- Laboratory testing
- Advanced neuroimaging (most often MRI) within 24 hours of symptom onset
- Intracranial and extracranial vascular imaging, possibly including carotid ultrasound and transcranial Doppler ultrasound, CT angiography or MR angiography
- Electrocardiogram assessment
- Echocardiogram for patients with a history or evidence of cardiac disease and for patients in whom other causes have been ruled out
- 30-day heart rhythm monitoring
- Pre-discharge education
- Follow-up care with a neurologist and the patient’s primary care physician
- A telephone call after 30 days to ask about recurrent events and feedback on care
- Follow-up assessment for compliance with medications and lifestyle changes such as weight management, smoking cessation, exercise, nutrition, etc.
- Screening for cognitive impairment and for depression, with treatment targeted before discharge
The Andrew F. Anderson Emergency Center has an MRI system located within the center, which facilitates prompt screening of patients with suspected TIA. Our goal is to ensure that all TIA patients are evaluated thoroughly as quickly as possible to minimize short-term stroke risk.
Stroke and TIA Risk Factors
- high blood pressure
- high cholesterol
- diabetes
- heart disease, especially atrial fibrillation
- smoking
- physical inactivity
Other factors such as age (older than 55), ethnicity, and family history of stroke can contribute to one’s risk of stroke
Stroke and TIA FAQs
What is the best treatment for TIA?
Once a Rhode Island Hospital provider diagnoses the cause of the transient ischemic attack (TIA), a treatment plan will be developed to address the issue and to prevent a stroke from occurring. Treatment options vary depending on the underlying cause of the TIA, and your provider may recommend medication, surgery, or a balloon procedure (angioplasty).
What medications are used to treat TIA?
Rhode Island Hospital providers will determine the best medication based on the cause of the patient’s attack.
Often, antiplatelet medications, like aspirin, Aggrenox, and Clopidogrel, are prescribed for TIAs because they help reduce the ability of blood platelets to stick together into clots. Blood clots are a common cause of TIAs and strokes.
During tests to diagnose the DIA, other related health issues may be found, such as high blood pressure, high cholesterol, and atrial fibrillation – irregular heartbeats. Providers will prescribe medications to treat them based upon the patient’s personal medical history.
Can lifestyle changes help prevent future TIAs?
Implementing lifestyle changes, such as modifying one's diet and incorporating regular exercise, can effectively reduce the likelihood of patients experiencing transient ischemic attacks. The guidance and expertise of medical professionals play a crucial role in determining the most beneficial lifestyle modifications for each patient, taking into account their individual health history.
How quickly should TIA be treated?
It is important for those who suspect they are having a TIA to be seen by medical professionals quickly for diagnosis and treatment. Patients who think they have had a TIA should proceed directly to an emergency room as quickly as possible.
What is the long-term outlook for someone who has had a TIA?
Despite the heightened risk of strokes, individuals who have experienced TIAs can still enjoy long, fulfilling lives. Making healthy lifestyle changes under the advisement of their personal providers can help patients achieve positive outcomes.
What is the risk of having another TIA or stroke after having one TIA?
People who have experienced a TIA have a 10 to 20 percent chance of having a stroke within 90 days of their attack, according to research published in the American Heart Association journal Stroke.