Not So Transient?: A Narrative Review on Cognitive Impairment After Transient Ischemic Attack.

Transient ischemic attack (TIA) is traditionally viewed as a self-resolving episode of neurological change without persistent impairments and without evidence of acute brain injury on neuroimaging. However, emerging evidence suggests that TIA may be associated with lingering cognitive dysfunction. Cognitive impairment is a prevalent and disabling sequela of ischemic stroke, but the clinical relevance of this phenomenon after TIA is less commonly recognized. We performed a literature search of observational studies of cognitive function after TIA. There is a consistent body of literature suggesting that rates of cognitive impairment following TIA are higher than healthy controls, but the studies included here are limited by heterogeneity in design and analysis methods. We go on to summarize recent literature on proposed pathophysiological mechanisms underlying the development of cognitive impairment following TIA and finally suggest future directions for further research in this field.
Competing Interests: Dr Kasner discloses consultation/Scientific Advisory/Data Safety Monitoring board membership/clinical trial support by Bayer, Bristol Meyers Squibb, Medtronic, Diamedica, and W.L. Gore & Associates; Editorial Board membership with UpToDate. Dr Rothstein discloses grant funding from the American Heart Association. Dr Witsch discloses grant funding from the American Heart Association and the National Institutes of Health and has received fees from medicolegal consulting. Dr Hamilton discloses membership on the Board of Directors of the American Neurological Association and Trustee, Evelyn F. McKnight Brain Research Foundation. The other authors report no conflicts.