Prevailing conditions misdiagnosed as TIA were postural hypotension, syncope, vertigo, seizures, anxiety, confusion, and complete stroke.
The symptoms of a transient ischaemic attack (TIA) are the same as those of a stroke, but they only last for a few minutes or hours.
The rate of TIA misdiagnosis among TIA clinic referred patients was 45.8%. Among the 230 patients in inpatient setting, the rate of TIA misdiagnosis was 60.0%. A hospital discharge diagnosis of TIA was observed in 54.3% of hospitalized patients; however, only 24.8% had the final diagnosis of TIA.
One of the most common stroke mimics is a seizure, which researchers believe account for as many as 20% of all stroke mimics. Other common stroke mimics include migraines, syncope, sepsis, brain tumor and metabolic derangement (low sodium or low blood sugar).
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).
A TIA is a temporary clot in your brain, so it doesn't always cause damage that would show up on a scan. If doctors are not sure what caused your symptoms, you may have a magnetic resonance imaging scan (MRI). This can rule out other causes of the symptoms, such as bleeds or abnormalities in the brain.
Blood biomarkers are promising to aid in the diagnosis, risk stratification, and individual treatment of minor stroke and TIA.
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.
You will likely have a head CT scan or brain MRI. A stroke may show changes on these tests, but TIAs will not.
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.
Diagnosis and Tests
Diagnostic testing consists of either a computed tomogram (CT) or magnetic resonance imaging (MRI) scan of the brain and carotid arteries to determine the possible cause of the TIA.
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.
Although a TIA should not have a long-term impact on your daily activities, you must stop driving immediately. If your doctor is happy that you have made a good recovery and there are no lasting effects after 1 month, you can start driving again.
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).
You do not need to be admitted to hospital because of a TIA, but this is often done because of the absence of an alternative. Many TIA clinics now offer a “one-stop” service for which the patient is assessed, investigated (or investigated before the appointment), and given results at the same session.
The American Heart Association guideline on TIA states that “it is reasonable to hospitalize patients with TIA if they present within 72 hours” if the predicted risk of stroke is high or an outpatient work-up cannot be completed within 2 days; however, this statement has a “C” level of evidence.
To significantly reduce the risk of stroke, a person who has experienced a TIA must seek the proper follow-up care immediately after the episode. Streib recommends that all patients visit an emergency room during or immediately after a TIA to receive imaging of their brain and blood vessels.
Most people who have a mini-stroke feel fine after the event. In fact, many people don't even realize they've had one! Symptoms might include weakness, numbness, tingling, vision changes or difficulty speaking. Most symptoms are temporary and dissipate within minutes but sometimes can last up to 24 hours.
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 .
Residual symptoms after transient ischaemic attack (TIA) The symptoms of a TIA are similar to that of stroke, but they may only last a short while, certainly no more than 24 hours. If symptoms last longer than 24 hours but are mild usually this would be defined as a 'minor stroke'.