The noninvasive evaluation of the transient ischemic attack

While the need for a thorough evaluation in the event of a transient ischemic attack is obvious, the diagnostic possibilities are, unfortunately, numerous and include cerebral hypoperfusion as well as ulcerative and stenotic extracranial vascular disease. The assessment, therefore, must include a thorough history and physical examination as well as noninvasive and invasive testing. While arteriography is still the standard diagnostic procedure, it is not without risk; and, thus, noninvasive testing has become increasingly important in our practice. However, because of the varied etiology of TIAs, the interpretation and accuracy of noninvasive testing must be carefully evaluated. Not only is it important to know the physiologic basis of each test, but also its diagnostic limitations.