A GP guide to brief neurological disturbances

Distinguishing symptoms as either ischaemic or non-ischaemic can be difficult on clinical grounds alone but is greatly aided by neurovascular imaging

10 minutes to read

7th July 2021

Transient neurological attacks (TNA) in the elderly are analogous to chest pain and require prompt investigation and treatment to identify ischaemic aetiologies and minimise subsequent stroke risk.
Clinical acumen cannot reliably distinguish ischaemic from non-ischaemic TNA causes.
All patients with TNAs of potentially ischaemic aetiology require a comprehensive workup, including extra- and intracranial vascular imaging and MRI.
CT/CT angiography is readily accessible and provides strong prognostic information regarding future stroke risk, helping guide treatment decision-making.
MRI sensitively identifies infarction, including in TNA patients otherwise deemed low risk.

Transient neurological attacks (TNA) are common in the elderly and increase in frequency with age.^1,2

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