Do not ignore transient brain dysfunction
TIA or transient ischemic attack or mini paralysis is "a brief episode of neurologic dysfunction caused by lack of blood supply to a specific area of the brain or eye, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction or brain attack", said Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA.
It is a neurological emergency; its early recognition can identify patients who may benefit from preventive therapy or from surgery of large vessels such as the carotid artery.
The initial evaluation of suspected TIA and minor non disabling ischemic paralysis includes brain imaging, neurovascular imaging, and a cardiac evaluation. Laboratory testing is helpful in ruling out metabolic and hematologic causes of neurologic symptoms.
TIA or minor non disabling ischemic paralysis is associated with a high early risk of recurrent paralysis. The risk of paralysis in the first two days after TIA is approximately 4 to 10 percent.
Immediate evaluation and intervention after a TIA or minor ischemic reduces the risk of recurrent stroke.
Risk factor management is appropriate for all patients. Currently viable strategies include blood pressure reduction, statins, antiplatelet therapy and lifestyle modification, including smoking cessation.
For patients with TIA or ischemic stroke of atherothrombotic, lacunar (small vessel occlusive), or cryptogenic type, antiplatelet agents should be given. For patients with atrial fibrillation and a recent ischemic stroke or TIA, the treatment is blood thinners. For patients with carotid blockages surgery is needed.