Diagnostic criteria for transient ischemic attacks and the challenges facing accurate diagnosis скачать в хорошем качестве

Diagnostic criteria for transient ischemic attacks and the challenges facing accurate diagnosis

Hanne Christensen, MD, PhD, MSci, from the University of Copenhagen, Copenhagen, Denmark, discusses current diagnostic criteria and the difficulties faced by clinicians in diagnosing transient ischemic attacks (TIAs). Traditional definitions of a TIA assume that rapid symptom resolution is indicative of a transient ischemic insult. For example, the World Health Organization (WHO) criteria for diagnosing a TIA is based on a rapidly developed focal neurological deficit, with symptoms of less than 24 hours and no apparent non-vascular cause. However, updated criteria from the American Heart Association published in 2009 recommended a tissue-based approach, necessitating the absence of infarction on brain imaging in addition to symptom resolution for a TIA diagnosis. This change was based on the observation that MRI with DWI demonstrates lesions in ~40% of patients presenting with TIA symptoms, and DWI positivity is associated with a 6-fold increased risk of recurrent stroke at 1 year. Ischemic stroke is typically diagnosed where a DWI-positive lesion is identified. However, some evidence suggests that patients without these DWI lesions can have similar risks of stroke as those with lesions. This makes it difficult for neurologists to effectively determine risk from TIAs. Recorded at the 9th Congress of the European Academy of Neurology (EAN) 2023 held in Budapest, Hungary. These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.