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Diagnosis and treatment for TIA

TIAs can be mimicked by tumors, seizures, low blood sugar, or balance-labyrinthine disorders (dizziness-producing disorders). A careful diagnosis must be made. Doppler ultrasonography, magnetic resonance angiography, or invasive arteriography can confirm the presence of stenosis and identify the affected artery. If patients with carotid TIAs have a documented obstruction of > 70 per cent in the carotid artery, endarterectomy significantly reduces the chance of a stroke compared with medical therapy alone. For an obstruction of < 30 per cent, medical therapy is preferred.
Antiplatelet drugs or anticoagulants are used for treatment. These are used when the portion of the blocked artery lies within the skull and therefore cannot be operated or when both major arteries of the neck (vertebral and carotid arteries) are affected.

Heparin is used initially for daily attacks; a warfarin derivative can be used for less frequent attacks, (heparin and warfarin are drugs which do not allow the blood to clot, therefore they are called as anti¬coagulants).

For patients with occasional TIAs secondarv to atherothroscleroitic plaques, antiplatelet drugs are tried before starting anticoagulants. Antiplatelet drugs prevent the clotting of blood by reducing stickiness of the platelets. Antiplatelet drugs should be continued indefinitely. Aspirin in low dose and or clopidrogel are the antiplatelet drugs used commonly.

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