Transient ischemic attack

Transient ischemic attack, as a rule, refers to any sudden focal deficiency that has developed, completely regressed in less than twenty-four hours. This definition differs breadth and variety of symptoms. It should be noted that the condition can not always be caused by ischemia. For example, a migraine attack or an epileptic focal syndrome is accompanied by neurological manifestations. Preservation of ischemia symptoms for more than one hour may indicate that a separate area of the brain tissue underwent a heart attack.

Specific manifestations of the condition indicate that the pathological process involves a site that is supplied with blood through a certain artery (middle cerebral, carotid and other).

Transient ischemic attack has pathophysiological mechanisms. This fact is indicated by the stereotyped nature, duration and frequency of repeated episodes.

So, for example, short-term (fifteen or less minutes), repeated (from five to ten times per day), of one type, weakness attacks in the entire arm or hand with the presence (or absence) of speech disorders may indicate proximal constriction or occlusion of the artery accompanied by Insufficiency in the collateral blood supply. This condition leads to focal ischemia in the cortex of the opposite hemisphere of the brain. However, on the other hand, one attack of speech disorder and weakness in the hand or hand for twelve hours is noted with low blood flow due to embolism. Together with this, it is likely that the area of the infarct is formed in the frontal lobe on the left.

Acute disturbance of cerebral circulation in the basin of one of the penetrating arteries causes the development of a lesion center not exceeding one centimeter. This condition is designated as lacunar transient-ischemic attack. Conditions in the vertebral-basilar system, if they are the result of distal (bilateral) or proximal basilar stenosis in the vertebral arteries, are usually manifested by attacks of dizziness, dysarthria and double vision.

Thus, the transient ischemic attack is provoked by two causes: embolism and focal blood flow lowering. In the first case, the mechanism of development of the state is obvious. To a lesser extent, the emergence of TIA against the background of a local decrease in blood supply to the brain has been studied. In all likelihood, a decrease in the influx is associated with arterial stenosis or occlusion to a critical extent. Of great importance is the insufficient collateral blood supply of the ischemic region. In addition, it is necessary to take into account the elasticity of the vessel wall, blood viscosity and other factors. Transient ischemic attack in such forms is considered as true, that is, as episodes of non-embolic genesis.

The states regress completely. However, their occurrence is a warning about the likelihood of stroke in the future. Thus, the pathophysiological mechanisms of these two states should be taken into account in the aggregate. It should be noted that the doctor is unable to assist the patient with a transient ischemic attack, without knowing the reasons for its occurrence. With this condition, a specific diagnosis is needed.

Obligatory hospitalization is experienced by patients older than forty-five years old and having complaints over the previous five years (without age registration). Therapy is prescribed for cardiovascular diseases, including atherosclerosis, after no more than two days from the time the transient ischemic attack occurred. Treatment is carried out in a hospital after the necessary research activities to confirm the syndrome. Therapy is aimed at preventing relapses of the condition, as well as the occurrence of a stroke, a heart attack.