Nearly half of the stroke risk following a TIA is incurred within the first two days, so immediate action may be necessary to prevent the impending stroke.
TIA is a clinical syndrome presenting as acute loss of focal cerebral or monocular function, due to inadequate cerebral or ocular blood supply, and lasting less than 24 hours. Although TIA is often referred to as a ‘mini-stroke’ (i.e. transient ischaemia in the brain), the definition here also includes an attack of ischaemia in the eye, because these also indicate a risk of impending stroke and they are therefore managed in a very similar way.
Accurate diagnosis of TIA usually depends entirely on the history. In most cases the symptoms and signs have already gone by the time the patient seeks medical help.
| Types of symptom |
Unilateral weakness or clumsiness
Slurring of speech in clear consciousness (particularly if accompanied by a facial droop)
Sudden loss of language (dysphasia) in clear consciousness |
Simultaneous bilateral weakness
Confusion (but beware: jumbled speech could represent a TIA with dysphasia)
Loss of memory
Isolated vertigo (illusory sense of spinning or other motion)
Faintness |
| Characteristics of these symptom |
Abrupt focal loss of neurological function
Complete recovery within 24 hours
Known vascular risk factors |
Gradual onset
Evolution of symptoms (e.g. spread from one body part to another or gradual change in the character of the symptoms)
Prominent positive features (pain, stiffness, very prominent tingling or other dysaesthesia) |
For referral forms for UCLH or please go to North Central London Cardiac and Stroke website link http://www.nclcn.org.uk for forms in all formats to refer to our service.
Urgent “high risk TIA” is now managed on the HASU by referral to The HASU Stroke Registrar on bleep 1145 or 07753739286, they are always available for advice if you are unsure of the ABCD2 score or want to discuss a patient further.
For low risk we ask that you send patients to the HASU for 8:30am the following morning, fasting ready for the consultant led assessment.