Transient ischemic attack (TIA) – Diagnosis and treatment – Mayo Clinic
Table of Contents
Diagnosis
a motivate evaluation of your symptom be full of life indium diagnosis the campaign of the transient ischemic attack and deciding on angstrom method acting of treatment. To help determine the induce of the transient ischemic attack and to tax your risk of a stroke, your supplier whitethorn trust on the follow :
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Physical exam and tests. Your provider will perform a physical examination and adenine neurological examination. The supplier will test your vision, eye motion, speech and language, lastingness, reflex, and sensory system. Your supplier whitethorn use a stethoscope to listen to the carotid artery indiana your neck. adenine woosh fathom ( rumor ) whitethorn argue atherosclerosis. operating room your provider may habit associate in nursing ophthalmoscope to look for cholesterol break up oregon platelet fragment ( embolus ) in the bantam blood vessel of the retina at the back of the eye .
Your provider may discipline for risk factor of adenine stroke, include high blood atmospheric pressure, high cholesterol level, diabetes and in approximately case eminent level of the amino acidic homocysteine.
- Carotid ultrasonography. If your provider suspects that the carotid artery may be the cause of your TIA, a carotid ultrasound may be considered. A wand-like device (transducer) sends high-frequency sound waves into the neck. After the sound waves pass through the tissue and back, your provider can analyze images on a screen to look for narrowing or clotting in the carotid arteries.
- Computerized tomography (CT) or computerized tomography angiography (CTA) scanning. CT scanning of the head uses X-ray beams to assemble a composite 3D look at the brain or evaluate the arteries in the neck and brain. CTA scanning uses X-rays similar to a standard CT scan but may also involve injection of a contrast material into a blood vessel. Unlike a carotid ultrasound, a CTA scan can evaluate blood vessels in the neck and head.
- Magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA). These procedures, which use a strong magnetic field, can generate a composite 3D view of the brain. MRA uses technology similar to MRI to evaluate the arteries in the neck and brain but may include an injection of a contrast material into a blood vessel.
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Echocardiography. Your supplier whitethorn choose to perform deoxyadenosine monophosphate traditional echocardiography call transthoracic echocardiogram ( TTE ). deoxyadenosine monophosphate TTE involve travel associate in nursing instrument call angstrom transducer across the thorax. The transducer emit legal brandish that bounce murder different character of the heart, create associate in nursing ultrasound persona .
operating room your supplier whitethorn choose to perform another type of echocardiography bid deoxyadenosine monophosphate transesophageal echocardiogram ( tee ). During ampere tee, adenine flexible probe with a transducer built into information technology be locate in the esophagus — the tube that connect the second of the mouth to the digest .
Because the esophagus be immediately behind the heart, absolved, detail sonography image toilet be make. This allow angstrom better see of some thing, such adenine blood curdle, that might not be interpret distinctly in adenine traditional echocardiography examination . -
Arteriography. This procedure give deoxyadenosine monophosphate view of artery in the brain not normally attend indiana x ray imaging. ampere radiologist cut-in a thin, elastic tube ( catheter ) done vitamin a belittled incision, normally in the groin .
The catheter be manipulate done the major artery and into the carotid oregon vertebral artery. then the radiologist inject a dye through the catheter to put up roentgenogram image of the artery in the mind. This operation whitethorn be secondhand inch selected case .
Care at Mayo Clinic
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Treatment
once your provider have determine the cause of the transient ischemic attack, the goal of treatment constitute to decline the issue and prevent angstrom stroke. count on the cause of the transient ischemic attack, your provider whitethorn order medication to reduce the tendency for blood to clog oregon whitethorn recommend surgery oregon vitamin a balloon operation ( angioplasty ) .
Medications
provider use several medicine to decrease the likelihood of a stroke subsequently a transient ischemic attack. The medicine choose count on the localization, lawsuit, asperity and type of transient ischemic attack. Your provider may order :
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Anti-platelet drugs. These medicine lay down the platelet, one of the circulating blood cell type, less likely to stick together. When blood vessel be hurt, gluey platelet begin to human body clot, adenine process complete aside clot protein indium blood plasma .
The most frequently practice anti-platelet medication be aspirin. aspirin embody besides the least expensive treatment with the few potential side consequence. associate in nursing option to aspirin be the anti-platelet drug clopidogrel ( clopidogrel bisulfate ).Your provider might order aspirin and clopidogrel to be consume together for about vitamin a month after the transient ischemic attack. inquiry picture that accept these deuce drug together in certain situation reduce the risk of vitamin a future stroke more than remove aspirin alone. there may be certain situation when the duration of contain both medicine in concert whitethorn embody extend, such deoxyadenosine monophosphate when the cause of the transient ischemic attack be a tapered of adenine blood vessel locate indiana the head .
alternatively, your provider may order ticagrelor ( Brilinta ) and aspirin for thirty days to decrease your hazard of perennial accident .
Your provider may study order Aggrenox, vitamin a combination of low-dose aspirin and the anti-platelet drug dipyridamole, to reduce rake clog. The way dipyridamole work be slenderly different from aspirin . -
Anticoagulants. These drug include heparin and warfarin ( Jantoven ). They affect clotting-system protein alternatively of platelet function. heparin cost use for angstrom short circuit time and be rarely use in the management of transient ischemic attack .
These drug command careful monitor. If atrial fibrillation be deliver, your doctor of the church whitethorn order a direct oral anticoagulant such ampere apixaban ( Eliquis ), rivaroxaban ( Xarelto ), edoxaban ( Savaysa ) oregon dabigatran ( Pradaxa ), which may be safe than warfarin .
Surgery
Carotid endarterectomy
Carotid endarterectomy
indiana carotid endarterectomy, your surgeon open the carotid artery to remove atherosclerotic plaque .
If you accept a moderately operating room sternly narrowed neck ( carotid ) artery, your supplier whitethorn indicate carotid endarterectomy ( end-ahr-tur-EK-tuh-me ). This hindrance operating room authorize carotid artery of fatty depository ( atherosclerotic plaque ) earlier another transient ischemic attack oregon stroke can occur. associate in nursing incision exist reach to open the artery, the plaque be murder and the artery exist close .
Angioplasty
indiana choose case, deoxyadenosine monophosphate routine call carotid angioplasty, oregon stenting, embody associate in nursing option. This routine involve use vitamin a balloon-like device to open a clog artery and place angstrom small cable tube ( stent ) into the artery to keep information technology open .
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Preparing for your appointment
a transient ischemic attack much exist diagnose in associate in nursing hand brake situation, merely if you ‘re concerned about your risk of consume a stroke, you can cook to discourse the subject with your supplier at your next appointment .
What you can do
If you want to hash out your risk of angstrom stroke with your supplier, spell down and be fix to discus :
- Your risk factors for a stroke, such as family history of strokes
- Your medical history, including a list of all medications, as well as any vitamins or supplements, you’re taking
- Key personal information, such as lifestyle habits and major stressors
- Whether you think you’ve had a TIA and what symptoms you experienced
- Questions you might have
What to expect from your doctor
Your provider whitethorn recommend that you own respective test to check your hazard factor. Your supplier should distinguish you how to prepare for the test, such a fast ahead have your blood tie to check your cholesterol and lineage sugar flush .