Background

Definition

• Definition of TIA
  • traditionally based on time lasted less than 24 hours, with focal neurological dysfunction, abrupt onsest and had a vascular cause. Often, they have signs of brain infarction on MRI even though symptoms resolved.
  • An episode of TIA is considered to be a
    • mild stroke if brain infarction is identified; otherwise
    • it is a true TIA if symptoms resolve completely within 24 hours and there is no brain infarction detected based on MRI.

Epidemiology

• 85% of stroke are ischemic and 10% are hemorrhagic.
• Risk of stroke after TIA is 10% in 2 week and 50% within 48 hours.

Classification of Stroke

Types of stroke and incidence:

• Ischemic stroke
  • Large vessel disease — 30%
  • cardioembolic — 15%
    • Atrial fibrillation
    • mural thrombus after a myocardial infarct
    • thrombi associated with cardiomyopathy
    • prostetic cardiac valves
    • nonbacterial thrombotic merantic endocarditis (rare)
  • small vessel disease — 15%
  • uncertain type — 15%
• Hemorrhagic stroke — 10%
• Subarachnoid hemorrhage — 5%
  • SAH is traditional included as a cause of stroke.

Management

Principles

• Timely assessment to rule out stroke mimics and confirming diagnosis
• Decision of reperfusion therapy
• Stroke rehabilitation
• Secondary prevention