TIA and Minor Stroke

Tests and scans for transient ischaemic attack (TIA)

The diagnosis of TIA or minor stroke is normally made by a specialist on the basis of symptoms reported and a clinical examination. Some additional tests or scans will usually be undertaken to work out the cause of symptoms and the best treatment. These may include MRI (magnetic resonance imaging) or CT (computed tomography), scans of the head, blood pressure measurements, blood tests to check clotting, blood sugar and cholesterol levels, ECG (electrocardiogram) to look for an irregular heart rhythm, ultrasound (Doppler scan) of the carotid arteries to check for any narrowing reducing the blood flow. Sometimes an echocardiogram may be used to check for other forms of heart disease.
 
Most people had one or several of these tests. Many people knew the names of the tests and most had some idea about what they were testing for although sometimes if tests had been conducted whilst the person was still recovering from their TIA or minor stroke it could be difficult to remember the details.
People also recalled being asked questions to test their memory and understanding such as “Who is the prime minister?” “What date is it?” or being asked to recall their address or do simple maths.
There are standard questions that doctors use to identify whether memory parts of the brain are affected. 
Blood pressure
High blood pressure is a major risk factor for strokes. If blood pressure readings show that the blood pressure is raised then further tests may be needed to check the body’s functioning, such as urine and blood testing and having an ECG. Doctors can then advise which blood pressure drugs are needed. (See resources for more information)
Blood tests
Many of the people we spoke to returned to visit their GP, consultant, or stroke clinic for ‘check- ups’ at different intervals after the event, depending on their needs and circumstances. This might typically involve blood pressure checks, blood tests and monitoring medication (see ‘Monitoring and advice’). Patients who are prescribed warfarin have to have their blood monitored regularly to ensure that the dose is correct.
MRI scan
Many of the people we interviewed had one or several MRI scans at the hospital. Some had taken part in a research study and so may have had access to more than the standard tests (see ‘Taking part in TIA research).
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Electrocardiogram (ECG) and echocardiogram
ECGs detect heart rhythm changes such as an irregular heart beat due to atrial fibrillation which increases the risk of stroke (due to a potential build up of a blood clot inside the heart).This can be treated with medication such as warfarin which makes it more difficult for the blood to form clots.
Echocardiograms use ultrasound to detect how well the heart is pumping blood and to examine the pattern of blood flow through the heart. Occasionally blood can take a shortcut through a small hole in one of the heart walls, which can result in TIA and stroke and can be treated with anticoagulant medication or implanting a device to block the hole – recent research has not shown that devices work better than medication.
 
Carotid Doppler Scan
This test uses ultrasound to measure blood flow in the carotid arteries, which are a major supply of blood to the brain. It can detect the presence of narrowing in the artery that might mean that surgery would be an appropriate treatment to reduce the chance of a future stroke.


Last reviewed August  2013
Last updated August  2013

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