Sunday, January 15, 2006

transient ischemic attack (TIA, carotid obstruction)

Transient ischemic attacks are short-term losses of blood to the cerebral area with temporary episodes of neurologic dysfunction. They last less than 24 hours and usually only for a few minutes. TIAs may be caused by thrombus, emboli, hemorrhage, generalized hypoxia, or localized hypoxia. They commonly precede cerebral thrombosis. Drugs are often responsible, particularly thiazide, diuretics, reserpine compounds, and promazine derivatives because of their hypotensive effects. Anemia is often overlooked in the elderly as a cause of TIAs. Physical exertion or even standing for any length of time produces signs of TIAs if hemoglobin is below normal. Symptoms of TIAs include dizziness, diplopia (double vision), headache, weakness, vomiting, nausea, mental changes, loss of consciousness, and amaurosis fugax (transient loss of vision in one eye).
Treatment of TIAs should include the determination of its cause. Vasodilators, anticoagulant therapy, or drugs that inhibit platelet aggregation are alternatives for the treatment of TIA. Anticoagulant therapy, including aspirin, decreases the number of attacks. Surgical correction is possible if an isolated extracranial arterial lesion is found. If the TIAs persist and the risk of stroke outweighs the risk of surgery, a carotid endarterectomy may be performed. Education is an important part of the treatment. Since TIAs often precede a stroke it is essential that the person understands the symptoms and their importance.
Phipps, W. J. Medical Surgical Nursing. St. Louis: C. V. Mosby Co., 1983.

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