Evaluation and management of transient ischemic attack and minor cerebral infarction

Kelly D. Flemming, Robert D. Brown, George W. Petty, John Huston, David F. Kallmes, David G. Piepgras

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

After immediate intervention for cerebral infarction or transient ischemic attack (TIA), the primary goal is secondary prevention of future cerebral ischemia and prevention of complications related to the initial ischemic event. The goals of the diagnostic evaluation are to (1) determine potential contributing mechanisms (cardio-embolic, large-vessel disease of the extracranial and intracranial vessels, small-vessel disease, coagulation defects, and cryptogenic), (2) identify contributing risk factors (hypertension, hyperlipidemia, tobacco use, diabetes), and (3) complete the evaluation in a cost-effective and safe manner. We provide a sequential approach to the diagnostic evaluation of cerebral infarction or TIA to optimize diagnostic yield of testing, minimise cost and potential harm to the patient, and provide information that will change management. This systematic approach focuses on 6 important questions: (1) Are the symptoms consistent with a cerebral infarction or TIA (versus nonishemic pathology)? (2) Where does the ischemic event localize? (3) What etiologies and mechanisms of cerebral infarction and TIA are possible? (4) What is the prevalence of each potential etiology? (5) What treatments are available for this etiology? (6) What tests and studies are useful to evaluate fills etiology?

Original languageEnglish (US)
Pages (from-to)1071-1086
Number of pages16
JournalMayo Clinic proceedings
Volume79
Issue number8
DOIs
StatePublished - Aug 2004

ASJC Scopus subject areas

  • Medicine(all)

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