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Initial evaluation and management of transient ischemic attack and minor ischemic stroke

Karen L Furie, MD, MPH
Hakan Ay, MD
Section Editor
Scott E Kasner, MD
Deputy Editor
John F Dashe, MD, PhD


Patients with transient ischemic attack (TIA) or minor (ie, nondisabling) stroke are at increased risk of recurrent stroke, and therefore require urgent evaluation and treatment since immediate intervention may substantially reduce the risk of recurrent stroke.

This topic will review the diagnostic approach and early management of TIA and minor, nondisabling ischemic stroke.

Other aspects of transient cerebral ischemia are discussed separately. (See "Definition of transient ischemic attack" and "Etiology and clinical manifestations of transient ischemic attack" and "Differential diagnosis of transient ischemic attack and stroke".)

The management of patients hospitalized with acute stroke is reviewed elsewhere. (See "Initial assessment and management of acute stroke".)

How is TIA defined? — Transient ischemic attack (TIA) is now defined as a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction [1,2]. The end point, stroke, is biologic (tissue injury) rather than arbitrary (≥24 hours). In keeping with this definition of TIA, ischemic stroke is defined as an infarction of central nervous system tissue.


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Literature review current through: Sep 2016. | This topic last updated: May 17, 2016.
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