Evaluation of patient presenting with acute symptoms of possible TIA or minor ischemic stroke

CDUS: carotid duplex ultrasonography; CNS: central nervous system; CT: computed tomography; CTA: computed tomography angiography; ECG: electrocardiography; IV: intravenous; MRA: magnetic resonance angiography; MRI: magnetic resonance imaging; TCD: transcranial Doppler; TIA: transient ischemic attack.

* Can begin aspirin and statin therapy while awaiting results of remaining diagnostic studies if imaging is negative for hemorrhage and other nonischemic cause of symptoms.

¶ Patients who present within the appropriate time window after ischemic symptom onset and have a persistent neurologic deficit that is potentially disabling, despite improvement of any degree, should be treated with intravenous thrombolysis and/or mechanical thrombectomy in the absence of other contraindications. Further management of these patients is similar to that of other patients with a potentially disabling stroke.

Δ Viable strategies include antihypertensive therapy, antithrombotic therapy, statin therapy, and lifestyle modification; select patients with symptomatic cervical internal carotid artery disease may benefit from carotid revascularization.