Centre for Prevention of Stroke and Dementia
Nuffield Department of Clinical Neuroscience, John Radcliffe Hospital
Maria Assunção Tuna is a Senior Clinical Research Fellow at the Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford and Consultant in Neurology and Stroke in the Buckinghamshire Healthcare NHS Trust. She was previously a Consultant in Neurology at Centro Hospitalar do Porto, where she led the Hyperacute Stroke Unit. Dr Tuna studied medicine at Instituto de Ciencias Biomedicas Abel Salazar, University of Porto. She was awarded first prize in clinical epidemiology by the Lisbon Society of Medical Science for her master’s thesis on prognosis of transient neurological attacks and was subsequently selected for the Doctoral Programme for Physicians of the Calouste Gulbenkian Foundation. She undertook a doctorate in Clinical Neurosciences at the University of Oxford (‘A Population-Based Study of Transient Neurological Attacks: Incidence, Clinical Characteristics, Investigation, Aetiology and Prognosis’) under the supervision of Professor Peter Rothwell. Dr Tuna’s research in the Oxford Vascular Study focuses on the diagnosis, investigation and prognosis of typical and atypical transient ischaemic attacks and other transient neurological symptoms, to prevent stroke recurrence.

Presenter Of 1 Presentation

Risk of Transient Neurological Symptoms

Session Type
Main Theme Symposium
Date
29.10.2021, Friday
Session Time
10:00 - 11:30
Room
MAIN THEME A
Lecture Time
10:34 - 10:51

Abstract

Abstract Body

Transient neurological symptoms are due to acute ischaemia (TIA-Transient Ischaemic Attacks) or other non-ischaemic conditions (TIA mimics-migraine aura, focal seizure, amyloid spell, etc.). About 50% of patients with a suspected TIA/minor stroke have atypical TIA or TIA-mimic diagnosis. The evidence base for diagnosis of TIA is limited. Since acute ischaemic lesions on diffusion-weighted imaging are present in relatively few patients with a definite TIA, symptomatic diagnosis remains the mainstay of clinical practice. However, the widely accepted high level definition of a TIA as sudden onset, focal neurological deficit of presumed vascular origin lasting less than 24 hours provides no guidance on which symptoms are likely to be vascular in origin. It is crucial that patients with transient neurological symptoms have a correct diagnosis as it has fundamental implications for their investigation and treatment. Patients with isolated focal, negative non-progressive symptoms (non-consensus TIA) have a similar short and long-term risk of stroke as patients with classic-TIAs. Furthermore, non-consensus TIA patients have similar baseline investigation findings (atrial fibrillation, intracranial or extracranial vascular stenosis, patent foramen ovale, etc) as classic-TIAs. Although there is some evidence that non-specific transient neurological symptoms (transient neurological attacks) are associated with an increased risk of vascular events, there is still uncertainty about the risk of strokes after transient neurological symptoms that are non-focal or positive or progressive. The diagnosis of ischaemic and non-ischaemic transient neurological symptoms, their investigation and prognosis will be discussed.

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