Transient ischemic attack: what to do when what is called a “warning stroke”

According to the American Heart Association, in the face of what is called a transient ischemic attack, examinations must be carried out to prevent the occurrence of a real stroke.

A deformed mouth, weakness on one side of the body, speech disorders. These symptoms are those of a stroke, but not only. They also occur during a transient ischemic attack (TIA).

Also called a “warning stroke”, this phenomenon corresponds to a temporary blockage of blood flow in the brain.

Although the TIA itself causes no harm, nearly 1 in 5 sufferers develop a true stroke within 3 months. And for half of those, the accident occurs within two days. This is why it is essential not to take this warning lightly.

Identify patients to be hospitalized

“It’s very difficult to diagnose a TIA because patients are usually back to normal functioning at the time of consultation,” says Hardik P. Amin of Yale New Haven Hospital in Connecticut.

Nevertheless, given the associated risks, each patient should undergo several tests to determine if they are at risk of imminent stroke, and therefore require immediate hospitalization.

For this, the ABCD2 score was developed by the American Heart Association. It is based on the following elements: age, blood pressure, symptoms, duration of symptoms (more or less 60 minutes) and the presence of diabetes.

For patients with a high score associated with a high risk, preventive hospitalization is indicated.

In addition, the AHA recommends that several tests be performed on all patients suspected of having had a TIA: imaging of blood vessels in the head and neck, brain MRI, blood sugar test in the blood, possible infection, diabetes and cholesterol levels. A neurology consultation is also recommended.

“Systematically integrating this care would make it possible to effectively distinguish between patients to be hospitalized and those who can be monitored at home”, concludes Hardik P. Amin.