Medical History and Physical Exam for a Suspected TIA
The diagnosis of
transient ischemic attack (TIA) typically is based on
your medical history rather than a physical exam, because symptoms usually have gone
away by the time you seek medical attention.
The onset of one or more of the following symptoms without any
known injury to the head suggests that you may have had a TIA:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body
- Sudden vision changes
- Sudden trouble speaking
- Sudden confusion or trouble understanding simple statements
- Sudden problems with walking or balance
- A sudden, severe headache that is different from past headaches
Other causes of these symptoms need to be considered too. When
more than one symptom is present, the pattern of the symptoms can be used to
decide whether they were likely to be caused by a TIA. The doctor will note
which symptoms were present and which areas of the body were involved. This
may help the doctor find out which part of the brain was affected. He or she also will
note how long the symptoms lasted. Symptoms of a TIA usually go away in minutes
(10 to 20 minutes).
The doctor also may ask questions to find out other possible causes
for the symptoms, such as flu, inner ear problems, stress, rapid breathing, low
blood sugar (if you have diabetes), or seizure.
Other information from the medical history often
includes:
- Any history of previous TIAs.
- Any
family history of TIAs or strokes.
- The presence of risk factors for
TIA or stroke, such as high blood pressure (hypertension), smoking, diabetes,
high cholesterol, and heart disease, especially
atrial fibrillation.
- Any history of other
diseases that may increase the risk of TIA or stroke.
- What
medicines you are taking.
- A recent injury to the head or
neck.
- The use of oral contraceptives (birth control
pills).
- Any drug or alcohol use.
- Any history of
migraine headaches.
Your doctor usually
will do a physical exam to check your:
- Face, arms, and legs for symptoms of numbness,
tingling, weakness, or
paralysis.
- Vision for dimness, blurring,
double vision, or loss of vision in one or both eyes, which is often described
as a feeling that a shade is being pulled down over your
eyes.
- Speech for difficulty saying words.
- Ability to
understand words.
- Balance and the way you walk for any
unsteadiness or weakness in your legs.
The doctor also will:
- Check your blood pressure.
- Listen for
the swishing sound—a
bruit (say "broo-E")—of blood flow through an artery
in your neck. Abnormal sounds heard in a blood vessel may be a sign that a
blood vessel is partially blocked, which may increase your risk for having a
TIA or
stroke.
- Check for signs of
heart failure, such as swollen neck veins or crackling
sounds in your lungs. Heart failure increases your risk of having a TIA or
stroke.
- Listen to your heart for rapid, irregular heartbeats (atrial fibrillation).
- Check for decreased
pulses in your neck, arms, and legs (signs of blood vessel disease).
Credits
| By | Healthwise Staff |
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Specialist Medical Reviewer | Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation |
| Last Revised | September 19, 2011 |