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Tia slides These slides require professional interpretation and are not for personal diagnosis or treatment. Consult your doctor if you need a medical opinion.
TIAs -  size of the problem ,[object Object],[object Object],[object Object],[object Object],TIAs
Slides on TIAs Use and amend these slides for your lecture needs.  These slides are for Physicians and require medical interpretation.  They are not to be used for personal diagnosis, treatment or treatment recommendations.  Consult your doctor for any medical opinion. Email your comments or new slides for inclusion to stroke@compura.com
CBF ml/100g/min Normal Oligaemic Electrocortical function  affected Electrical failure Ionic pump failure Cell death 35 20 15 10 60 Thresholds of cerebral ischaemia
TIAs ,[object Object],[object Object],[object Object],TIAs
TIAs -  key questions ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA ,[object Object],[object Object],[object Object],[object Object],TIAs
Annual risk CVA, MI, vascular death following TIA minor CVA ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIAs -  site ,[object Object],[object Object],[object Object],[object Object],TIAs
TIAs Approximate frequencies of main causes of ischaemic stroke & presumably TIAs Rarities 5% Atherothromboembolism 50% Embolism - heart 20% Intracranial small vessel disease 25% TIAs
TIAs -  territory   Carotid  Either  Vertebrobasilar Dysphasia   +++ Monocular visual loss (am fugax)  +++ Dyspraxia, visuospatial problems  +++ Unilateral weakness   ++   -   + Unilateral sensory   ++   -   + Dysarthria*   +  -   +++ Dysphagia*   +  -   +++ Ataxia*   +++ Diplopia*   +++ Vertigo*   + Bilateral visual loss   +++ Bilateral sensory   +++ Crossed sensory/motor   +++ * = in isolation, not TIA + may occur - +++ v common TIAs
Transient ischaemic attacks TIAs
Carotid TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Amaurosis fugax ,[object Object],TIAs
Transient ischaemic attacks TIAs
Vertebrobasilar TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA -  diagnosis ,[object Object],[object Object],[object Object],[object Object],TIAs
TIA -  diagnostic criteria (i) ,[object Object],[object Object],[object Object],[object Object],[object Object],TIA
TIA -  diagnostic criteria (ii) ,[object Object],[object Object],[object Object],[object Object],TIA
TIA -  symptoms (i) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIA
TIA -  symptoms (ii) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIA
TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Carotid bruit ,[object Object],TIAs
Carotid bruit ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Carotid bruit + TIA ,[object Object],[object Object],[object Object],[object Object],TIAs
Carotid bruit ,[object Object],[object Object],[object Object],TIAs
Carotid bruit ,[object Object],[object Object],[object Object],[object Object],TIAs
TIAs -  routine   investigations ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA -  who to duplex scan (i) ? ,[object Object],[object Object],TIAs
TIA -  who to duplex scan (ii) ? ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA -  who to duplex scan (iii) ? ,[object Object],[object Object],[object Object],TIAs
EEG, CT and MRI in TIA ,[object Object],[object Object],[object Object],[object Object],TIAs
TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Stroke -  risk factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Stroke - prevalence of vascular risk factors -  first time ever cerebral infarct ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Any of = 80% TIAs
Risk CVA, MI, vascular death following TIA minor CVA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA -  risk of further CVA ,[object Object],[object Object],[object Object],[object Object],TIAs
TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA -  hospital admission ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIAs ,[object Object],TIAs
Risk reduction, non-fatal CVA/MI,  vascular & non-vascular deaths,  for antiplatelet Rx in TIA mild CVA 7.5% 0% 30% 16/12 15/1000 30% 15/12 14/1000 18% 15/12 13/1000 7% % reduction 15/12 months Rx 1/1000 events prevented % patients affected TIAs
Aspirin -  TIA & Stroke ,[object Object],TIAs
Drugs & ischaemic stroke ,[object Object],[object Object],[object Object],TIAs
Aspirin ,[object Object],[object Object],[object Object],[object Object],[object Object],NEJM 1997; 336: 973-9.
Dipyridamole retard  Risk reduction for   TIA In TIA/mild stroke - aspirin 50 mg, dipyridamol retard 200 mg bd, n = 6602 13.2% had TIA  2 yr. 12.6% had TIA  2 yr. 10.5% had TIA  2 yr. 16.4% placebo had TIA  2 yr. European stroke prevention study. J Neur Sci 1996; 143: 1-13.
CAPRIE - Clopidrogel ,[object Object],[object Object],[object Object],[object Object],Lancet 1997; 348: 1329-39
Aspirin secondary prevention ,[object Object],[object Object],TIAs
European stroke prevention study 2 ,[object Object],[object Object],[object Object],[object Object],TIAs
CAPRIE study ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Drugs & ischaemic stroke/TIA - arterial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Carotid stenosis ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Carotid endarterectomy ,[object Object],TIAs
Endarterectomy - TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Endarterectomy -  guidelines ,[object Object],[object Object],[object Object],TIAs
Symptomatic  carotid stenosis ,[object Object],[object Object],[object Object],TIAs
Symptomatic  carotid stenosis ,[object Object],[object Object],[object Object],TIAs
Asymptomatic carotid stenosis (ACS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Asymptomatic  carotid stenosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIAs -  practical points (1) ,[object Object],[object Object],[object Object],[object Object],TIAs
TIAs -  practical points (2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIAs -  dy/dx - transient deficit ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
dy/dx TIA ,[object Object],[object Object],[object Object],[object Object],[object Object],TIA
dy/dx TIA ,[object Object],[object Object],[object Object],[object Object],TIA
dy/dx TIA ,[object Object],[object Object],[object Object],[object Object],TIA
dy/dx TIAs ,[object Object],[object Object],[object Object],[object Object],[object Object],TIA
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],dy/dx TIA ,[object Object],[object Object],[object Object],[object Object],[object Object],TIA
dy/dx TIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIA
Migraine  vs TIA (i) ,[object Object],[object Object],[object Object],[object Object],TIA
Migraine  vs TIA (ii) ,[object Object],[object Object],[object Object],TIA
Migraine  with aura ,[object Object],[object Object],[object Object],TIAs
Danger signs  for ‘migraine’ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Migraine  without aura ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
Case history  TIA vs migraine ,[object Object],TIA
TIA  vs epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIA
Case history  TIA vs Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIA
Transient global amnesia ,[object Object],[object Object],[object Object],[object Object],[object Object],TIA
Intracranial structural lesions ,[object Object],[object Object],[object Object],[object Object],TIA
TIAs -  danger   ,[object Object],[object Object],[object Object],[object Object],[object Object],TIAs
TIA  vs structural lesion - case history ,[object Object],[object Object],[object Object],[object Object],[object Object],TIA
IC haemorrhage  & others (i) ,[object Object],[object Object],[object Object],TIA
IC haemorrhage  & others (ii) ,[object Object],[object Object],[object Object],TIA
[object Object],[object Object],[object Object],TIA Non-focal sudden neurological deficits (i)
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIA Non-focal sudden neurological  deficits (ii)
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TIA Non-focal sudden neurological deficits (iii)
TIA/mild CVA -  strategy (i ) ,[object Object],[object Object],[object Object],TIAs
TIA/mild CVA -  strategy (ii) ,[object Object],[object Object],[object Object],TIAs

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Tia

  • 1. Tia slides These slides require professional interpretation and are not for personal diagnosis or treatment. Consult your doctor if you need a medical opinion.
  • 2.
  • 3. Slides on TIAs Use and amend these slides for your lecture needs. These slides are for Physicians and require medical interpretation. They are not to be used for personal diagnosis, treatment or treatment recommendations. Consult your doctor for any medical opinion. Email your comments or new slides for inclusion to stroke@compura.com
  • 4. CBF ml/100g/min Normal Oligaemic Electrocortical function affected Electrical failure Ionic pump failure Cell death 35 20 15 10 60 Thresholds of cerebral ischaemia
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  • 13. TIAs Approximate frequencies of main causes of ischaemic stroke & presumably TIAs Rarities 5% Atherothromboembolism 50% Embolism - heart 20% Intracranial small vessel disease 25% TIAs
  • 14. TIAs - territory Carotid Either Vertebrobasilar Dysphasia +++ Monocular visual loss (am fugax) +++ Dyspraxia, visuospatial problems +++ Unilateral weakness ++ - + Unilateral sensory ++ - + Dysarthria* + - +++ Dysphagia* + - +++ Ataxia* +++ Diplopia* +++ Vertigo* + Bilateral visual loss +++ Bilateral sensory +++ Crossed sensory/motor +++ * = in isolation, not TIA + may occur - +++ v common TIAs
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  • 45. Risk reduction, non-fatal CVA/MI, vascular & non-vascular deaths, for antiplatelet Rx in TIA mild CVA 7.5% 0% 30% 16/12 15/1000 30% 15/12 14/1000 18% 15/12 13/1000 7% % reduction 15/12 months Rx 1/1000 events prevented % patients affected TIAs
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  • 49. Dipyridamole retard Risk reduction for TIA In TIA/mild stroke - aspirin 50 mg, dipyridamol retard 200 mg bd, n = 6602 13.2% had TIA 2 yr. 12.6% had TIA 2 yr. 10.5% had TIA 2 yr. 16.4% placebo had TIA 2 yr. European stroke prevention study. J Neur Sci 1996; 143: 1-13.
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Editor's Notes

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