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November 23, 2009
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Transient Ischemic Attack (TIA, Mini-Stroke) (cont.)

How is transient ischemic attack (TIA) diagnosed?

TIA is diagnosed by history and physical examination. Since most often the symptoms have resolved, the physician will need to take a good history from the patient and family or friends who witnessed the event. The physical exam will include careful attention to the neurologic examination. This may include:

  • Assess mental status to make certain the patient is alert and oriented.

  • Check eye range of motion and facial movement to evaluate the cranial nerves (the short nerves that run from the brain to the face and neck).

  • Listen to the neck with a stethoscope to detect abnormal sounds that may signal narrowing of the blood vessel (carotid bruits).

  • Check for a regular heart rhythm to rule out the presence of atrial fibrillation.

  • Examine the arms and legs for tone, power, and sensation.

  • Check coordination and balance.

If the diagnosis of TIA is made, further urgent testing is usually recommended, including:

  • Electrocardiogram (EKG) to confirm a regular heart rate

  • Computerized tomography (CT scan) of the brain to look for bleeding

  • Carotid ultrasound to look for narrowing of the large blood vessels in the neck

  • Routine blood tests may include a complete blood count (CBC) to look for anemia or low red blood cell count or too few platelets (thrombocytopenia). If the patient takes warfarin (Coumadin), a blood thinner, then an international normalized ratio (INR - a blood test that measures the degree of blood thinning) or prothrombin time (PT), may be performed to assess blood clotting measurements.

  • If there is concern that the heart is the source of blood clot or debris, then an echocardiogram or sound wave tracing of the heart may be considered.


Next: What is the treatment for transient ischemic attack (TIA)? »

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