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(Stroke. 2004;35:e13.)
© 2004 American Heart Association, Inc.

Letters to the Editor

Call TIAs "TIBs"

Stroke Program, Associate Professor of Neurology, University of South Florida, Tampa, Florida

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

The term transient ischemic attack (TIA) is problematic. New evidence of an even greater than previously appreciated risk of impending stroke is accumulating. The recent article by Lovett et al provides resounding data in support of this.¹ An article published several months previously is particularly pertinent in this regard. Albers and others were more forthright in their revocation of the long-overdue recision of the term TIA.² Albers et al recommended that we should keep the term TIA but that we must understand it should mean something different!

However, TIA and its connotations in clinical practice demand a catchy replacement acronym. The term must somehow satisfy medical and nonmedical people and yet be accurate, brief, and remembered. The term TIA was also regarded as a relatively benign syndrome with nonemergent status. This needs to be urgently corrected.

The call for a more appropriate and sinister term is particularly relevant.² We need to keep it short and self explanatory, and yet it must be accurate from a pathophysiological point of view. An abandonment of the term TIA in its present form may be unnecessary.

In my view, a term that can steal the popularity and yet metamorphose into a more appropriate acronym would be TIB: threatening infarct of the brain. TIB encompasses both transience and evolution into something more disastrous; it is biologic end point–based rather than a temporal parameter and incites or should kindle a sense of urgency among clinicians and laity alike.

1. Lovett JK, Dennis MS, Sandercock PAG, Bamford JC, Warlow CP, Rothwell PM. Very early risk of stroke after a first transient ischemic attack. Stroke. 2003; 34: e138–e140.[Medline] [Order article via Infotrieve]

2. Albers GW, Caplan LR, Easton DJ, et al. Sounding board: transient ischemic attack: proposal for a new definition. N Engl J Med. 2002; 347: 1713–1716.[Free Full Text]

Response

Stroke Prevention Research Unit, University Department of Clinical Neurology, Radcliffe Infirmary, Woodstock Road, Oxford, United Kingdom

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