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Question 1

Recall that you met Mr. C in the Patient Education section of this Module. He has just been told that a brief episode in which he couldn't talk clearly was most likely a TIA. The physicians in the emergency department and the consulting neurologist have both recommended that additional testing be done immediately in order to determine more precisely what has caused his problem. However, Mr. C is very reluctant to have any more tests at this time. He has a vacation planned to the Grand Canyon and asks you, "Doctor, can't this wait?"Why would you strongly urge him to have those tests right now? List at least one piece of information that supports your position; list two for a bonus.

Answer to Question 1

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The risk of stroke following a TIA is greatest in the first month, and remains high for the first year. Having had a TIA, he has about a 5% annual risk of stroke, and about an 8% combined annual risk of stroke, heart attack, or death in the next 5 years.  

TIA Facts

  • As many as 20% of patients who have a new stroke retrospectively report having prior TIAs 
  • After a TIA, the annual risk of stroke is about 5%(2.3%-6.7%) for the first five years. The risk that such a patient will have a stroke, myocardial infarction, or die decreases to about 8% annually over the same period.
  • Risk of stroke is highest during the first month. About 15%-30% of subsequent strokes occur during the first month, and 40%-50% occur during the first year.