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Neuroradiology

Transient ischaemic attack

(TIA), neurological episode in which a neurological deficit appears suddenly and clears completely within 24 hours. If the attack lasts longer but neurological signs disappear within 7 days the condition is called a reversible neurological deficit (RIND). Both conditions indicate a warning vascular event and should prompt a search for the possible mechanism, to avert further and more lasting deficits. Any source of possible emboli should be identified: cardiac (valvulopathy, atrial myxoma), or arterial, mainly carotid bifurcations and vertebral arteries. Rarely a giant, partially thrombosed, carotid cavernous aneurysm may be the cause of intracranial emboli. Once a possible embolic source in the supraortic vessels has been identified with Doppler or angio MR, performed also with intravenous gadolinium, angiography should be performed if endarterectomy or endovascular treatment is envisaged. Patients with high grade stenosis, greater than 70%, should be treated.

GS