Kintantis požiūris į praeinantįjį smegenų išemijos priepuolį.

Transient ischemic attack (TIA) has been described as a brief episode of focal neurologicaldys function caused by acute brain or retinal ischemia, without evidence of acute infarction. According to classical definition, acute focal symptoms of TIA resolve completely within 24 hours after the onset, however, their common duration is less than 1 hour. 33% of patients with transient neurological episode lasting up to 1 hour already have new ischemic lesions on diffusion weighted MRI scan, suggesting that 1 hour also does not demarcate events with and without brain tissue infarction. Therefore current guidelines endorse the following revised definition without any particular time-point: TIA - a transient episode of neurologicaldys function caused by focal brain, spinal cord, or retinal ischemia, without acute infarction. Transient ischemic attack has long been known as a precursor to ischaemic stroke. Up to 50% strokes after TIA occur within the first 2 days. The simple and reliable ABCD2 score was derived to provide a prediction of early stroke risk after TIA. Patients with TIA score risk points (indicated in parentheses) for each of the 5 following factors: age ≥60 years (1); blood pressure ≥140/90 mm Hg (1); clinical symptoms of focal weakness (2) or speech impairment without weakness (1); duration ≥60 minutes (2) or 10 to 59 minutes (1); diabetes (1). According to ABCD2 total scores stroke risk could be stratified as low (0-3), moderate (4-5) or high (6-7). Other suggested criteria of high risk of stroke after TIA are symptomatic carotid stenosis >50% and atrial fibrillation. Therefore ABCD2 score may be supplemented with carotid ultra sound evaluation and ECG. Recent SOSTIA and EXPRESS clinical trials evaluated the efficacy of early assessment and immediate implementation of preventive measures for patients after TIA. Results of urgent TIA management revealed up to 80% relative risk reduction of stroke within the following 90 days. [ABSTRACT FROM AUTHOR]