Accident ischémique cérébral et rétinien transitoire

Transient ischemic attack (TIA) refers to a neurological deficit lasting less than 24 hours and attributed to focal cerebral or retinal ischemia. Urgent evaluation and treatment are necessary to prevent definite stroke. Twenty to 30% of strokes are preceded by TIA. The 90-day risk of stroke after a TIA is about 10%. Rigorous clinical evaluation by a neurologist and brain imaging are needed due to numerous differential diagnoses. Episodes misdiagnosed as TIA are heterogeneous and include those due to migraine, seizure, peripheral vertigo, metabolic disorders, hemorrhagic stroke. TIA is a multiple-cause syndrome. The goals of diagnostic investigations are to identify TIA aetiologies requiring specific therapy and to assess modifiable risk factors. Antiplatelet agents are beneficial for the patient with TIA and atherosclerosis, anticoagulation therapy for patients who have a major cardiac source of embolism or artery dissection, and endarterectomy is optimal therapy for extracranial carotid artery stenosis of 70% or greater. Finally, since TIA may be considered a sign of generalized atherosclerotic disease, it is important to identify potential coronary artery disease, or arteriopathy of the lower limbs, and to control all modifiable risk factors.