EAN 2023 | Caveats of a tissue-based diagnosis of transient ischemic attack

Hanne Christensen, MD, PhD, MSci, from the University of Copenhagen, Copenhagen, Denmark, talks about the tissue-based diagnosis of transient ischemic attack (TIAs) and how it can be combined with clinical approaches to maximize benefits. Diagnostic criteria from the American Heart Association published in 2009 recommended a tissue-based approach, necessitating the absence of infarction on diffusion-weighted imaging (DWI) MRI in addition to symptom resolution at 24 hours for a TIA diagnosis. However, an MRI scan can miss DWI lesions, especially in the posterior of the brain, and MRI degradation might occur with delayed imaging capture. Additionally, nonspecific symptoms or examination findings can lead to diagnostic uncertainty. Therefore, a comprehensive workup is important in combination with imaging findings, to identify higher risk patients who require close monitoring. Considering additional MRI features and other forms of analysis such as CT angiography can help neurologists to gain a more detailed picture of vasculature and better understand TIAs and their causes. Recorded at the 9th Congress of the European Academy of Neurology (EAN) 2023 held in Budapest, Hungary.

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