How do neurologists diagnose transient ischemic attack: A systematic review
| العنوان: | How do neurologists diagnose transient ischemic attack: A systematic review |
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| المؤلفون: | Dar Dowlatshahi, Sophia Gocan, Chu Q Wang, Grant Stotts, Michel Shamy, Tess Fitzpatrick, Aline Bourgoin, Candyce Hamel |
| المصدر: | International Journal of Stroke |
| بيانات النشر: | SAGE Publications, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Canada, medicine.medical_specialty, Clinical Decision-Making, Review, 030204 cardiovascular system & hematology, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Risk Factors, Atrial Fibrillation, medicine, Humans, Transient (computer programming), Neurologists, Transient ischemic attack, Stroke, decision analysis, business.industry, Stroke mimics, stroke mimic, medicine.disease, stroke, Neurology, Ischemic Attack, Transient, Stroke prevention, Hypertension, stroke prevention, business, 030217 neurology & neurosurgery |
| الوصف: | Background Identifying and treating patients with transient ischemic attack is an effective means of preventing stroke. However, making this diagnosis can be challenging, and over a third of patients referred to stroke prevention clinic are ultimately found to have alternate diagnoses. Aims We performed a systematic review to determine how neurologists diagnose transient ischemic attack. Summary of review A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using MEDLINE, Embase, and the Cochrane Library databases. Publications eligible for inclusion were those that included information on the demographic or clinical features neurologists use to diagnose transient ischemic attacks or transient ischemic attack–mimics. Of 1666 citations, 210 abstracts were selected for full-text screening and 80 publications were ultimately deemed eligible for inclusion. Neurologists were more likely to diagnose transient ischemic attack based on clinical features including negative symptoms or speech deficits. Patients with positive symptoms, altered level of consciousness, or the presence of nonfocal symptoms such as confusion or amnesia were more likely to be diagnosed with transient ischemic attack–mimic. Neurologists commonly include mode of onset (i.e. sudden versus gradual), recurrence of attacks, and localizability of symptoms to a distinct vascular territory in the diagnostic decision-making process. Transient ischemic attack diagnosis was more commonly associated with advanced age, preexisting hypertension, atrial fibrillation, and other vascular risk factors. Conclusions Neurologists rely on certain clinical and demographic features to distinguish transient ischemic attacks from mimics, which are not currently reflected in widely used risk scores. Clarifying how neurologists diagnose transient ischemic attack may help frontline clinicians to better select patients for referral to stroke prevention clinics. |
| تدمد: | 1747-4949 1747-4930 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4ce646e6b6a2b299eb5d2644173b46b2 https://doi.org/10.1177/1747493018816430 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....4ce646e6b6a2b299eb5d2644173b46b2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17474949 17474930 |
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