Pre PACES Podcast #13 Transient Ischaemic Attacks
Jul 18, 2021
Dr. Jen Collinson, an Acute Medicine registrar with expertise in stroke medicine, shares her insights on transient ischaemic attacks (TIAs). She discusses the importance of thorough patient history, focused examinations, and the distinction between TIAs and strokes. Jen highlights common presentation features and necessary investigations like neuroimaging. The episode also covers differential diagnoses, lifestyle advice for vascular risk reduction, and practical tips for communicating with patients about their condition.
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Definition: TIA Versus Stroke
- A TIA is a transient focal neurological deficit of vascular cause that resolves within 24 hours.
- A stroke is similar but symptoms persist beyond 24 hours, making the 24-hour cutoff the exam definition.
Start Open, Then Drill Into Symptoms
- Start history with an open question and let the patient describe the event in their own words.
- Then drill down on exact features: distribution, unilateral vs bilateral, sudden onset and duration.
Differentiate Speech Problems Precisely
- Distinguish dysarthria from dysphasia by asking if they knew what they wanted to say and whether they could understand others.
- Ask about reading and comprehension to help detect language problems.