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Diagnostic criteria for transient ischemic attack

https://doi.org/10.14412/2074-2711-2018-2-12-19

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Abstract

The diagnosis of transient ischemic attack (TIA) is fraught with problems; particularly this concerns the differentiation of TIA with its mimicking conditions. Explicit diagnostic criteria can improve the accuracy of TIA recognition. The authors of this paper propose new TIA diagnostic criteria

Objective: to elaborate TIA diagnostic criteria and to determine their sensitivity in a group of patients with TIA, as well as their specificity in those who suffered from migraine with aura from Russia and Denmark.

Patients and methods. TIA diagnostic criteria were developed using the International Classification of Headache Disorders (ICHD) and the data available in the literature on migraine with aura and on the clinical characteristics and diagnosis of TIA. The sensitivity of the criteria was tested in a prospective study of 120 patients who developed TIA before the elaboration of these criteria. The patients were questioned in the acute period of the disease through detailed semi-structured interviews. Eligible patients had focal brain or retinal ischemia with resolution of symptoms within 24 hours without acute brain tissue damage, as evidenced by diffusion-weighted magnetic resonance imaging (n=112) or computed tomography (n=8). These criteria were also tested for specificity in Danish (n=1390) and Russian (n=152) patients suffering from migraine with aura, the diagnosis of which was established according to ICHD-3 beta.

Results and discussion. The sensitivity of the proposed criteria in TIA patients was 99%. The specificity in the Danish and Russian patients with migraine with aura was 95% and 96%, respectively.

Conclusion. The new TIA diagnostic criteria are characterized by high sensitivity and specificity. These will be able to improve the diagnosis of TIA. It is recommended that the testing of these criteria in patients with TIA should be continued in future investigations.

About the Authors

E. R. Lebedeva
Urals State Medical University; International Headache and Facial Pain Center «Europe–Asia»; OOO «Medical Association “New Hospital”»
Russian Federation

Department of Emergency Medical Care, Urals State Medical University 

Contact: Elena Razumovna Lebedeva

3, Repin St., Yekaterinburg 620028



N. M. Gurary
Urals State Medical University; OOO «Medical Association “New Hospital”»
Russian Federation

Department of Emergency Medical Care, Urals State Medical University 

3, Repin St., Yekaterinburg 620028



J. Olesen
University of Copenhagen
Denmark

Department of Neurology, University of Copenhagen, Danish Headache Center 

Nordre Ringvej 57, 2600 Glostrup, Copenhagen, Denmark



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For citation:


Lebedeva E.R., Gurary N.M., Olesen J. Diagnostic criteria for transient ischemic attack. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):12-19. (In Russ.) https://doi.org/10.14412/2074-2711-2018-2-12-19

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ISSN 2074-2711 (Print)
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