Transient ischemic attack causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The most common cause of a TIA is an embolus (a small blood clot) that occludes an artery in the brain. This most frequently arises from an atherosclerotic plaque in one of the carotid arteries (i.e. a number of major arteries in the head and neck) or from a thrombus (i.e. a blood clot) in the heart due to atrial fibrillation. Other reasons include excessive narrowing of large vessels due to an atherosclerotic plaque and increased blood viscosity due to some blood diseases. TIA is related with other medical conditions like hypertension, heart disease (especially atrial fibrillation), migraine, cigarette smoking, hypercholesterolemia, and diabetes mellitus.

Causes

The etiology of TIA may be divided in to following based on the pathophysiology involved:

Atherosclerotic or large artery TIA

  • Caused by atherosclerosis of internal carotid artery at origin or intracranially
  • Also called low flow TIA
  • Lasts few minutes to hours
  • May cause recurrent TIAs producing stereotyped symptoms based on the branches of vessel involved

Embolic TIA

  • Caused by an embolic source from artery or heart
  • Common causes of embolism include atrial fibrillation and ventricular thrombus
  • Usually lasts hours

Lacunar or small vessel TIA

  • Involves small penetrating intracerebral vessels
  • Usually caused by atheroscerotic narrowing of small blood vessels or lipohyalanosis
  • May invlove internal capsule, basal ganglia or thalamus

Dissection

  • Commonly cause symptoms due to cerebral ischemia or embolism
  • Interruption of blood flow at the petrous portion of internal carotid artery or at the level of C1-C2 of vertebral artery as it enters foramen transversarium
  • Symptoms may last from minutes to hours to days.
  • May be detected by neurovascular imaging

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Certolizumab pegol, iloperidone, interferon gamma, oprelvekin, sorafenib
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

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