transient ischemic attack often called tia is diagnosed by a history and physical examination. since most often the symptoms have resolved the physician will need to take a good history from the patient and family or friends who witnessed the event. the physical exam will include careful attention to the neurologic examination. this may include: assess mental status to make certain the patient is alert and oriented. check eye range of motion and facial movement to evaluate the cranial nerves (the short nerves that run from the brain to the face and neck). listen to the neck with a stethoscope to detect abnormal sounds that may signal narrowing of the blood vessel (carotid bruits). check for a regular heart rhythm to rule out the presence of atrial fibrillation. examine the arms and legs for tone power and sensation. check coordination and balance. if the diagnosis of tia is made further urgent testing is usually recommended including: electrocardiogram to confirm a regular heart rate. computerized tomography of the brain to look for bleeding. carotid ultrasound to look for narrowing of the large blood vessels in the neck. routine blood tests may include a complete blood count to look for anemia or low red blood cell count or too few platelets (thrombocytopenia). if the patient takes warfarin (coumadin) a blood thinner then an international normalized ratio (inr - a blood test that measures the degree of blood thinning) or prothrombin time (pt) may be performed to assess blood clotting measurements. if there is concern that the heart is the source of blood clot or debris then an echocardiogram or sound wave tracing of the heart may be considered.
how is transient ischemic attack or tia diagnosed?