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(Stroke. 2008;39:2400.)
© 2008 American Heart Association, Inc.

Emerging Therapies

EXPRESS Transient Ischemic Attack Study

Speed the Process!

Pierre Amarenco, MD Oscar Benavente, MD

From INSERM U-698 and Denis Diderot University–Paris VII (P.A.), France; and the University of Texas (O.B.), San Antonio, Texas.

Correspondence to Pierre Amarenco, Department of Neurology and Stroke Center, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France. E-mail pierre.amarenco@bch.aphp.fr

Marc Fisher MD Kennedy Lees MD Section Editors:

Key Words: TIA • emerging therapies

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

	Introduction

 
Retinal and cerebral transient ischemic attacks (TIAs) are a falsely benign form of brain attack. After a TIA, the risk of completed stroke is up to 8% within the first 8 to 15 days.^1,2 TIAs precede a completed stroke in as many as 25% of patients with stroke.³ Because diffusion-weighted imaging shows a small amount of brain tissue damage in most cases of TIA, TIAs often represent ministrokes⁴ and hence should be considered an emergency.⁵ Since their description in the 1950s, TIAs were considered as giving to clinicians the best opportunity to avoid a completed stroke and its devastating personal, social, or sometimes fatal consequences.⁶

However, this is only true provided TIAs are detected and treated. Awareness and rapid management are the real challenges of TIAs. It is striking how quickly the concept of a stroke unit and a stroke team was developed and implemented in the past 2 decades for the treatment of morbidity and comorbidities of patients with a completed stroke and then to speed the pre- and intrahospital delay of tissue plasminogen activator therapy within 3 hours of symptom onset.⁷ Although the concept of TIA arose in the 1950s and effective therapies for stroke prevention post-TIA had been well established,⁶ the first publication of the effectiveness of round-the-clock access (SOS-TIA) to diagnose and treat TIA without delay only appeared in 2007.⁸ Simultaneously, the EXPRESS study brought convincing evidence that the combination of proven therapies given to patients within 24 hours of symptom onset dramatically reduced the risk . . . [Full Text of this Article]

This article has been cited by other articles:

				N Sprigg, C Machili, M E Otter, A Wilson, and T G Robinson A systematic review of delays in seeking medical attention after transient ischaemic attack J. Neurol. Neurosurg. Psychiatry, August 1, 2009; 80(8): 871 - 875. [Abstract] [Full Text] [PDF]