Introduction. Brain magnetic resonance imaging (MRI) is the preferred and most sensitive modality after transient ischemic attack (TIA) or minor stroke. It should include diffusion-weighted imaging (DWI) and should be completed within 24 hours of symptom onset1,2; its use is 3-fold.
However, mounting evidence suggests that an MRI within 1 to 2 days of a TIA could spot evidence of a stroke that may disappear in time. MRIs can detect tissue damage even when symptoms are temporary. The sophisticated imaging technique can detect stroke lesions that may become less apparent quickly.
In a previously reported study, 31% of TIA patients showed an acute infarction visualized by MRI including DWI. A strong association was found between neurological symptoms, speech dysfunction and weakness and an evidence of acute infarction by MRI including DWI (Al-Khaled and Eggers, 2013).
An MRI scan is most often used. This type of scan uses a strong magnetic field and radio waves to create an image of your brain.
Neurologists were more likely to diagnose transient ischemic attack based on clinical features including negative symptoms or speech deficits.
Symptoms can be caused by other problems, so the specialist doctor or nurse will listen carefully to you and confirm if you've had a TIA. You may have a brain scan, but not everyone needs a scan. You'll have tests for health problems linked to stroke, such as high blood pressure, high cholesterol and diabetes.
5 How- ever, earlier studies have shown that MRI may not detect acute strokes in 10-20% of patients. 4-6 Few clinical details of the false-negative cases were provided. Although several aspects of MRI techniques, computer software, and scan interpretations have been improved, false-negative MRI results may still occur.
Always treat a TIA as seriously as you would a stroke. "Even though the symptoms resolve, there might be damage to the brain, so you need to see a neurologist," Dr. Rost advises.
The underlying cause of a TIA often is a buildup of cholesterol-containing fatty deposits called plaques (atherosclerosis) in an artery or one of its branches that supplies oxygen and nutrients to the brain. Plaques can decrease the blood flow through an artery or lead to the development of a clot.
Tests will be done to rule out a stroke or other disorders that may cause the symptoms: You will likely have a head CT scan or brain MRI. A stroke may show changes on these tests, but TIAs will not.
TIAs are often an early warning sign that a person is at risk of stroke. About 1 in 3 people who has a TIA goes on to experience a subsequent stroke. The risk of stroke is especially high within 48 hours after a TIA .
MAGNETIC RESONANCE IMAGING
Standard MRI images (T1 and T2) are good at detecting vasogenic edema that is present in the subacute phase of stroke and is seen at greater than 24 hours to several days.
MRI can detect ischemic stroke within the first few hours of onset. MRI can differentiate between brain tissue at risk for infarction and brain tissue that has been irreparably damaged. Lacunar infarcts and brainstem infarcts can be identified by MRI, whereas CT scans have difficulty due to the surrounding bone.
While partial seizures and complicated migraine are the most common and important TIA/stroke mimics, on occasion panic attacks, conversion disorder, vertigo, and syncope can also be confused with TIA. Panic attacks occasionally involve focal neurologic symptoms, but more typically the symptoms are vague and random.
In many cases, a stroke can be fatal. Unfortunately, misdiagnosis of a TIA is fairly common. One expert even estimated that misdiagnoses account for up to 160,000 deaths or debilitating brain injuries annually, as a prompt medical response to a TIA is critical to the prevention of a full-blown stroke.
Symptoms of a TIA come on suddenly. You may feel perfectly fine one minute and then suddenly develop difficulty speaking or moving one side of your body. Sometimes the symptoms will come and go several times in a short period of time.
Dipyridamole and aspirin — Dipyridamole is a medication that may be given after a TIA to reduce the risk of stroke. It is often given as an extended-release form, combined with aspirin (aspirin-extended-release dipyridamole, brand name: Aggrenox). It is taken two times per day.
Introduction. The diagnosis of transient ischemic attack (TIA) can be notoriously difficult, mainly because it is often solely based on history taking. Patients suspected of a TIA require an urgent assessment with timely start of antithrombotic therapy to reduce the risk of an early ischemic stroke.
Causes of a transient ischaemic attack (TIA)
This blockage is usually caused by a blood clot that's formed elsewhere in your body and travelled to the blood vessels supplying the brain, although it can also be caused by pieces of fatty material or air bubbles.
MRI is known to generally be more sensitive than CT in the detection of ischemia, and current experimental MRI studies with Na23 show even better sensitivity for acute stroke imaging [40]. However, the detection of hemorrhage, especially smaller hemorrhage, is not so straightforward with MRI.
TIAs look like strokes in terms of signs and symptoms, but they are temporary. In other words, they leave no lasting brain damage or residual symptoms. However, they serve as a warning sign that a person is at higher risk of a major stroke and should seek immediate medical attention.
TIA does not cause widespread, permanent damage, but it may result in small pockets of dead brain cells. It is often called a “warning stroke” because it precedes 12% of all strokes, and 9-17% of TIA patients have a stroke within 90 days.
Some people might have more than one TIA and it is possible to have several TIAs in a short space of time (for example, several TIAs within a day).
Around 70%reported that their TIA had long- term effects including memory loss, poor mobility, problems with speech and difficulty in understanding. 60%of people stated that their TIA had affected them emotionally. There is no way to tell whether a person is having a TIA or a stroke when the symptoms first start.