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Current Management of Transient Ischemic Attack

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Abstract

Transient ischemic attack (TIA) is a precursor to ischemic stroke. At least half of patients with TIA have a new, small ischemic lesion demonstrable on magnetic resonance imaging using a diffusion weighted sequence. The risk of subsequent major stroke is 10–20% in the next 3 months with much of that risk front-loaded in the first week. Strategies to identify and treat high-risk patients need to be defined. The optimal treatment approach and the timing of interventions, both medical and surgical, remains unknown. In general, aspirin is the first line of treatment to prevent further stroke. Other antiplatelet agents such as clopidogrel alone or in combination with aspirin and the combination aspirin/extended-release dipyridamole may be administered. Endarterectomy or carotid stenting is of great benefit to patients with TIA secondary to stenosis in the extracranial carotid artery.

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Acknowledgments

Dr Hill is the supported by the Heart and Stroke Foundation of Alberta, North-West Territories, Nunavut, and the Canadian Institute for Health Research. Dr Hill had also received honoraria for speaking at symposia sponsored by Boehringer Ingelheim and Sanofi-Synthelabo.

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Authors and Affiliations

  1. Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada

    Padmavathy N. Sylaja & Michael D. Hill

  2. Department of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada

    Michael D. Hill

  3. Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Hospital, Room 1242A, 1402 28th Street NW, Calgary, Alberta, T2N2T9, Canada

    Michael D. Hill

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  1. Padmavathy N. Sylaja
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Correspondence to Michael D. Hill.

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Sylaja, P.N., Hill, M.D. Current Management of Transient Ischemic Attack. Am J Cardiovasc Drugs 7, 67–74 (2007). https://doi.org/10.2165/00129784-200707010-00006

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