Transitory ischemic attack: an underrecognized

Abstract

A transient ischemic attack (TIA) is an early manifestation of cerebrovascular disease and represents an important opportunity to prevent future ischemic strokes. Although symptoms resolve completely in most cases, current scientific evidence suggests that the risk of recurrence and stroke is particularly high in the first few hours and days following the event. The objective of this narrative review was to analyze the available scientific evidence on transient ischemic attack, focusing on its conceptual development, epidemiology, pathophysiology, risk factors, clinical manifestations, diagnosis, neuroimaging, prognostic stratification, treatment, and secondary prevention. The narrative review was conducted by reviewing international biomedical databases and documents produced by scientific societies related to cerebrovascular diseases. The reviewed literature suggests that advances in neuroimaging have significantly changed the definition and diagnostic approach to TIA, allowing for better identification of patients at high risk of recurrent events. Furthermore, it has been demonstrated that the early implementation of therapeutic and secondary prevention strategies significantly reduces the incidence of subsequent strokes.

However, significant challenges remain in terms of early symptom recognition, access to specialized care, and the use of standardized diagnostic protocols. It is concluded that transient ischemic attack should be considered a true neurological emergency requiring immediate evaluation and early preventive intervention to reduce the burden of cerebrovascular disease and improve clinical outcomes.