Identifying the Cause

Additional measures to change the risk of stroke after a patient has had a first TIA or stroke (secondary prevention)

A major goal of evaluating patients who have had a TIA or mild ischemic stroke is to determine the specific cause of the cerebral ischemia, so that the most appropriate therapy can be initiated to prevent recurrence.  As a reminder, the most common causes of cerebral ischemia in patients over the age of 50 are:

• Embolus
  - Artery to artery
  - Heart to intracranial vessel (cardiogenic emboli)
• In situ thrombus (usually formed on ruptured plaque)
• Small vessel disease, usually secondary to hypertension or diabetes 

Patients with TIAs or mild strokes should be evaluated very promptly

These patients have a heightened risk of stroke (or a second more serous stroke), especially within the first few days to weeks. Depending on what the diagnostic evaluation indicates about the most likely cause of theTIA or first stroke, specific medical and/or surgical therapies may be recommended in addition to general measures to reduce stroke risk.

Medical therapies if suspected cause is arterial thrombosis [LINK to arterial thrombosis]

Medical therapies if suspected cause is cardiogenic emboli [LINK to cardiac emboli]

Surgical therapies [LINK to surgical therapies]