TIA or stroke with transient overt signs?

doi:10.1136/bmj.a2158

Published 20 October 2008, doi:10.1136/bmj.a2158
Cite this as: BMJ 2008;337:a2158

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Transient ischaemic attack

TIA or stroke with transient overt signs?

The first 150 words of the full text of this article appear below.

Rapid and direct assessment by secondary care services is thekey to successful management of transient ischaemic attack (TIA)and stroke.¹ A continuing challenge is the persistent notionthat such critical events should be channelled through primarycare, with attendant delays, in a way that would be unthinkablefor a "major" stroke.²

A radical rethink of our descriptors of stroke disease is timely.Unhelpful terminology can obstruct treatment and cloud priorities.³In addition to dropping the misleading couplet "minor stroke",we should also abandon TIA, a term dating from the 1950s thatpredates modern knowledge of stroke and sophisticated neuroimaging.⁴

Increasingly, the benefit of urgent assessment and intervention,²and evidence of subtle persistent neurological deficits afterTIA,⁵ are eroding the distinction between stroke and TIA. Strokewith transient overt symptoms (STOS) would provide a bettermatch with patient needs, accurate definition of the syndrome,and ideally prompt urgent assessment and . . . [Full text of this article]

Desmond O’Neill, consultant physician in stroke and geriatric medicine¹, Ronan Collins¹, Tara Coughlan¹

¹ Stroke Service, Adelaide and Meath Hospital, Dublin 24, Ireland

doneill@tcd.ie

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