The goal is to improve the arterial blood supply to the brain and prevent the development of a stroke. Treatment of recent TIA (within the prior 48 hours) usually requires admission to the hospital for evaluation of the specific cause and determination of long-term treatment. Underlying disorders should be treated appropriately, including such disorders as hypertension, heart disease, diabetes, arteritis, and blood disorders. Smoking should be stopped. Treatment of symptoms of blood disorders (such as erythrocytosis, thrombocytosis, or polycythemia vera, which include an increase in the number of some of the cellular components of blood) may include phlebotomy, hydration, and treatment of the underlying (causative) blood disorder. Antihypertensive medications may be used to control high blood pressure. Medications to lower cholesterol may be useful in reducing high blood cholesterol levels.
Platelet inhibitors and anticoagulant medications (blood thinners) may be used to reduce clotting. Aspirin is the most commonly used medication; others include dipyridamole, clopidogrel, Aggrenox or heparin, coumadin, or other similar medications. Treatment may be continued for an indefinite time period.
A reduced amount of sodium in the diet to help control high blood pressure; diet for diabetics; reduced dietary fat, or other dietary changes may be recommended.
Surgery (carotid endarterectomy, removal of atherosclerotic plaque from the carotid arteries in the neck) may be appropriate for some people, particularly those with carotid artery stenosis of greater than 70% of the artery and without coexisting terminal disease or dementia.
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