Emergency Department (ED) Triage for Transient Ischemic Attack (TIA)

Abstract

Purpose of Review

Patients with transient ischemic attacks (TIAs) have a higher risk for stroke and vascular events. Specialized and organized management, if rapidly initiated in the emergency department (ED), reduces the vascular burden of TIA. This review summarizes the rationale for optimal triage of patients suspected with TIA in the ED, focusing on early diagnosis confirmation, individual risk stratification, and management.

Recent Findings

New evidence is emerging on the yield of integrating clinical scales with advanced neuroimaging of the vessels and brain for improved diagnosis and risk stratification in patients with TIA. The “TIA clinic” model of management is associated with the lowest long-term cardio-cerebrovascular recurrence rate ever reported.

Summary

TIA are vascular emergencies that require a specialized, systematic evaluation to confirm the diagnosis of an ischemic mechanism, identify high-risk source of brain ischemia and initiate a tailored therapeutic strategy. TIA triage in the ED should organized as part of a “TIA clinic program” that unifies the expedited specialized management of the patient, in collaboration with stroke neurologists.

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Correspondence to Carlo W. Cereda.

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Carlo W Cereda declare no conflict of interest, discloses consulting fees for Bayer, Bristol Myers Squibb, Boehringer, and Jean Marc Olivot Disclosure consulting fees Astra Zeneca, Servier, Bristol Myers Squibb, Boehringer. Jean-Marc Olivot declare no conflict of interest.

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This article is part of the Topical Collection on Cardiovascular Disease and Stroke

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Cereda, C.W., Olivot, JM. Emergency Department (ED) Triage for Transient Ischemic Attack (TIA). Curr Atheroscler Rep 20, 56 (2018). https://doi.org/10.1007/s11883-018-0755-5

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Keywords

  • Transient ischemic attack (TIA)
  • Acute cerebrovascular syndrome (t-ACS)
  • Diagnosis
  • Risk stratification
  • Management of TIA