Characteristics of TIA and its management in a tertiary care hospital in Pakistan.
Background:Transient ischemic attack (TIA) is described as a brief episode of neurological dysfunction caused by focal brain ischemia, with clinical symptoms typically lasting less than an hour, and without evidence of acute infarction. Recent studies depict TIA as a particularly unstable condition. Risk of stroke is greater than 10% in the first 90 days after an index TIA. The presentation, prognosis and intervention for TIA have not been reported in South-Asians in a developing country. Method: A retrospective chart review was done for 158 Patients who were admitted with the diagnosis of TIA, as defined by ICD 9 code 435, from January 2003 to December 2005 at the Aga Khan University Hospital, Karachi, Pakistan. The data was entered and analyzed in SPSS version 14.0. FINDINGS: Among 158 Patients, 57.6% were male and 41.1% were female. The common presenting symptoms were motor symptoms (51.3%), speech impairment (43%), sensory impairment (34.8%) and loss of balance/vertigo (29.1%). The median delay in presenting to the hospital was 4 hours. Those with motor symptoms were found to present earlier. The study showed that only 60.8% of all the Patients presenting with TIA received any immediate treatment out of which 44.7% received aspirin. Neuroimaging was used in 91.1% of the Patients. Of all the TIA Patients 9.1% converted to stroke with 50% doing so within the first 24 hours.
The natural history of TIA from this developing nation is comparable to international descriptions. A large percentage of Patients are still not receiving any immediate treatment as recommended in available guidelines, even in a tertiary care hospital.
BMC Research Notes
(2008). Characteristics of TIA and its management in a tertiary care hospital in Pakistan.. BMC Research Notes, 1, 73.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_med_neurol/44