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A detailed and complete history is vital to the diagnosis, because the specific deficits demonstrated help the physician determine which area of the brain was affected. Often, the diagnosis may rest on the history alone, as symptoms and signs may have completely disappeared by the time one gets to the hospital.

A physical examination should include a neurological examination, which may be abnormal during an episode but normal after the episode has passed. It may also be used to rule out a stroke in evolution rather than TIA. Blood pressure may be high. Listening with a stethoscope over the carotid or other artery may show a bruit, an abnormal sound caused by irregular blood flow, which may indicate atherosclerotic plaque or a thrombus in the area.

Tests for TIA may include tests to determine the cause and extent of blood vessel involvement, and to rule out stroke or other disorder that may cause the symptoms.

bullet CBC and PT tests are used to rule out hematologic disease.
bullet Head CT scan or cranial MRI are used to rule out focal lesions as the cause of symptoms. MRA can get a picture of the blood vessels non-invasively.
bullet A carotid duplex (ultrasound) may be performed if there is suspected carotid stenosis.
bullet An echocardiogram may be performed to look for a source of embolism.
bullet A cerebral arteriogram may be performed if there is suspected localized vascular (blood vessel) disease, such as carotid artery stenosis ("hardening") or vasculitis (inflammation of the blood vessels in the brain).

Other tests and procedures may be performed to determine underlying disorders and to rule out other disorders that may cause the symptoms. This may include examination for hypertension, heart disease, diabetes, high blood lipids, vasculitis, and peripheral vascular disease. These tests and procedures may include:

bullet blood glucose
bullet blood chemistry
bullet serum lipids
bullet ESR (Sedimentation rate)
bullet tests for syphilis
bullet ECG
bullet chest X-ray
bullet echocardiography (if heart disorder is suspected)
 

Stroke Warning Signs

bullet Sudden numbness or weakness of the face, arm or leg, especially on one side of the body   
bullet Sudden confusion, trouble speaking or understanding   
bullet Sudden trouble seeing in one or both eyes   
bullet Sudden trouble walking, dizziness, loss of balance or coordination   
bullet Sudden, severe headache with no known cause



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Original date 3/1/96 Revised 9/24/14