Transient Ischemic Attack (TIA) evaluation by non neurologists versus neurologists

Abstract

Stroke ranks as the third cause of death in western industrialized countries. and is the second leading cause of death world wide, killing 5 million people each year. Thirty- one percent of stroke survivors need help for activities ·or daily life, 20% are unable to walk without assistance, 16% live in asylum,

and 71% suffer from disturbances of speech even seven years after stroke

(Iglseder et al, 2004).

Cerebrovascular disease account for 6.8% of disability adjusted life in Europe (Olesen and Leonardi, 2003). The economic burden of stroke is enormous; the direct and indirect costs were estimated to be 53.6 billion dollars for the US (lglseder et al, 2004).

Despite the advanced possibilities of acute stroke treatment with tissue plasminogen activator and other promising experimental strategies, the best approach to reduce the burden of stroke remains prevention (Gorelick, 1995).

The risk of stroke after transient ischemic attack (TlA) is estimated to be

20% in the tirst 90 days. The risk is time dependant with 50% of the stroke occurring in the first 48 hours. Hence TIA is no longer considered a benign condition but, rather, a critical harbinger of impending stroke. (Johnston and Michael, 2004).

Transient ischemic attack (TIA) provides a golden opportunity for stroke prevention, so it should be managed as medical emergency with proper investigations to determine the mechanism of ischemia and subsequent preventive therapy (Johnston and Michael, 2004).

Previous studies contirmcd that, although TIA has an imp011ant role in the secondary prevention of stroke, its concept is sti II understood di tTcrcntly by