A transient ischemic attack (TIA) refers to a temporary dysfunction of brain tissue in a specific area due to insufficient blood supply. The common disease cause is cerebral atherosclerosis, and some patients may develop cerebral infarction.

bubble_chart Diagnosis

1. Medical History and Symptoms:

Internal carotid artery transient ischemic attack (TIA) may present as sudden confusion, generalized or focal seizures, limb numbness, monoplegia, hemiplegia, homonymous hemianopia, aphasia, apraxia, crossed amaurotic hemiplegia, etc.; Vertebrobasilar artery TIA manifests as vertigo, syncope, drop attacks, amaurosis, diplopia, visual distortion, visual field defects, balance disorders, bulbar palsy, amnesia, agnosia, etc. There are often precipitating factors, and each episode lasts no more than 24 hours without residual symptoms during the interictal period. The medical history should inquire about the onset (acute or gradual), characteristics of symptoms, possible triggers, previous similar episodes, duration of symptoms, and interictal symptoms.

2. Physical Examination Findings:

During an attack, signs are as described above. In the interictal period, some patients may exhibit mild signs such as hemiparesis, nystagmus, corneal reflex asymmetry, pharyngeal wall and tendon reflex asymmetry, accommodation or convergence reflex impairment.

3. Auxiliary Examinations:

Doppler ultrasound and angiography of the extracranial segments of the carotid and vertebral arteries may reveal vascular stenosis or incomplete occlusion, and/or reduced blood flow. Electronystagmography in vertebral artery TIA may show nystagmus after neck hyperextension and rotation. Visual and brainstem auditory evoked potentials may be abnormal. Electroencephalography and rheoencephalography may show reduced wave amplitudes. These tests help identify the disease cause and confirm the diagnosis.

It should be differentiated from partial epilepsy and Ménière's syndrome.

bubble_chart Treatment Measures

Actively treat the primary disease; for recurrent cases, preventive measures should be taken, including long-term use of aspirin (0.1g, once daily), dipyridamole (50–100mg, three times daily), ticlopidine (0.25g, once daily), alginic sodium diester (100mg, three times daily), and invigorating blood and resolving stasis Chinese medicinals. For significant stenosis or occlusion caused by large cervical vessel plaques, options such as carotid endarterectomy or carotid artery stenting may also be considered.