Signs and Tests

A detailed and complete history is vital to the diagnosis, because the specific deficits demonstrated correspond well with the specific lesion or affected area of the brain. For example, involvement of one arm or leg may indicate damage to one brain artery, while loss of vision or difficulty talking may suggest a different location.

Physical examination may include neurologic examination, which may be abnormal during an episode but normal after the episode has passed. It may also be used to rule out a stroke in evolution rather than TIA. The eyes may be examined, including a check of the pressures within the eye. Blood pressure may be high. Auscultation with a stethoscope over the carotid or other artery may show a bruit, an abnormal sound caused by irregular blood flow, which may indicate atherosclerotic plaque or a thrombus in the area.

Tests for TIA may include tests to determine the cause, extent of blood vessel involvement, and to rule out stroke or other disorder that may cause the symptoms.

• CBC and PT tests are used to rule out hematologic disease.
• Head CT scan or cranial MRI are used to rule out focal lesions as the cause of symptoms.
• A carotid duplex (ultrasound) may be performed if there is suspected carotid stenosis.
• An echocardiogram may be performed to look for a source of embolism.
• A cerebral arteriogram may be performed if there is suspected localized vascular (blood vessel) disease, such as carotid artery stenosis ("hardening") or vasculitis (inflammation of the blood vessels in the brain).

• blood glucose
• blood chemistry
• serum lipids
• tests for syphilis
• ECG
• chest X-ray
• echocardiography (if heart disorder is suspected)

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