Acute ischemic stroke and transient ischemic attack

Maria I. Aguilar

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations

Abstract

Stroke refers to the clinical syndrome of sudden onset of focal or global disturbance of central nervous system function, with no apparent cause other than a vascular cause. Ischemic stroke is responsible for about 80% of all strokes, intracerebral hemorrhage (ICH) for 15%, and subarachnoid hemorrhage (SAH) for 5%. A transient ischemic attack (TIA) has the same symptom complex as a stroke, but with a resolution of these symptoms within 24 hours. Most TIAs though resolve within 1 hour, it is increasingly understood that TIAs and minor strokes represent a continuum of disease. Some suggest that the time-based definition of TIA yield to a tissue-based definition, as approximately one-third of people with clinically diagnosed TIAs will actually have structural changes visible on neuroimaging, such as diffusion-weighted MRI scanning. This chapter discusses about acute ischemic stroke and transient ischemic attack, the mechanism of pathophysiology, epidemiology, thrombolysis and clot retrieval, organization of care, treatment of acute ischemic stroke using antiplatelet agents, anticoagulants, HMG CoA reductase inhibitors, cooling, and neuroprotective agents; management of complications by controlling for blood pressure and blood glucose; and treating brain edema with mannitol, glycerol, corticosteroids, and craniectomy. In summary, TIA is a neurological emergency, and as such mandates prompt evaluation with the goal to identify the etiologic cause of the event and implement early therapy to prevent TIA recurrence, stroke, cardiovascular events, and death.

Original languageEnglish (US)
Title of host publicationEvidence-Based Neurology
Subtitle of host publicationManagement of Neurological Disorders: Second Edition
PublisherWiley Blackwell
Pages53-66
Number of pages14
ISBN (Electronic)9781119067344
ISBN (Print)9780470657782
DOIs
StatePublished - Dec 11 2015

Keywords

  • Acute
  • Management
  • Stroke
  • TIA

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Aguilar, M. I. (2015). Acute ischemic stroke and transient ischemic attack. In Evidence-Based Neurology: Management of Neurological Disorders: Second Edition (pp. 53-66). Wiley Blackwell. https://doi.org/10.1002/9781119067344.ch6