The statement gives medical providers guidance on how to assess patients who suspect they have had a TIA. The condition occurs when a temporary blockage of blood to the brain produces stroke-like symptoms that quickly resolve.
Since symptoms tend to resolve within an hour, diagnosing suspected TIAs can be difficult, according to the guidelines.
For years, TIAs have been nicknamed mini-strokes, but the term is a misnomer. In a press release, AHA officials say a TIA “is more accurately described as a warning shot.” Although less serious than full-blown strokes, TIAs lead to full strokes in about 1 in 5 patients within three months. Almost half of these severe strokes occur in just two days, the scientists write.
The guidelines call on medical providers to use both brain imaging and risk assessment scores to determine if a stroke has damaged the brain and to indicate patients at risk for a larger stroke. Providers should review symptoms and medical history, then perform a CT scan to rule out conditions that may mimic TIA.
Patients should have an MRI within 24 hours of the onset of symptoms, the report recommends.
Rural and underserved hospitals without neurologists on site or with limited access to imaging should participate in telemedicine networks that connect providers to each other and transfer patients to central hospitals for imaging or organize outpatient MRIs , as directed.
“Incorporating these steps for people with suspected TIAs can help identify patients who would benefit from hospitalization, versus those who could be safely discharged from the ER with close follow-up,” said Hardik P. Amin, an associate professor of neurology who chaired the association’s scientific statement writing committee, in the press release. Amin is also the Medical Director of Stroke at Yale New Haven Hospital.
TIAs share the same symptoms as strokes: facial drooping, arm weakness, slurred speech, dizziness. People with other cardiovascular risk factors such as obesity, high blood pressure and smoking are at higher risk.