Cerebrovascular accident (CVA) and Transient Ischaemic Attacks (TIA) both occur when the blood supply to the brain is interrupted. The difference occurs in the definition of the timing; a stroke produces symptoms that last for at least 24 hours, whereas symptoms produced by a TIA are transient (less than 24 hours), usually resolving fully within 30 minutes.
Perform FAST (Face / Arms / Speech / Time) examination.
Terminology used in RACE:
All patients with suspected transient ischaemic attack (TIA), i.e. focal neurological symptoms due to focal ischaemia that have fully resolved, should have urgent clinical assessment. (Lavallee et al. 2007 [25]; Rothwell et al. 2007 [26]) (Refer to the
'Practical Information' section for further useful information)
Patients with symptoms that are present or fluctuating at time of initial assessment should be treated as having a stroke and be immediately referred for emergency department and stroke specialist assessment, investigation and reperfusion therapy where
appropriate. (Lavallee et al 2007 [25]; Rothwell et al. 2007 [26])
In pre-hospital settings, high risk indicators (e.g. crescendo TIA, current or suspected AF, current use of anticoagulants, carotid stenosis or high ABCD2 score) can be used to identify patients for urgent specialist assessment. (Lavallee et al. 2007 [25]; Rothwell et al. 2007 [26])
Improved Stroke patient outcomes rely on:
Intracranial (within the skull but outside of the brain tissue) haemorrhage:
The brain has three membranes layers (called meninges) that lay between the bony skull and the actual brain tissue. The purpose of the meninges is to cover and protect the brain. Bleeding can occur anywhere between these three membranes. The three membranes are called the dura mater, arachnoid, and pia mater.
Intracerebral haemorrhage (haemorrhagic stroke) and/or intraventicular haemorrhage:
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