23: Cerebral Circulation Diseases TIAs and CVAs: Assessment, Analysis, and Associated Dental Management Guidelines

23

Cerebral Circulation Diseases TIAs and CVAs: Assessment, Analysis, and Associated Dental Management Guidelines

TRANSIENT ISCHEMIC ATTACKS (TIAS)

TIA is associated with temporary cerebral ischemia due to cerebral vascular spasm. No permanent brain damage occurs. Once the spasm is released, the symptoms disappear. The symptoms last for a few seconds to a few minutes, but occasionally they can last for a few hours. Resolution of symptoms occurs within 24 hours. Patients with a history of TIA have a 50–60% chance of progressing to CVA/stroke.

Acute TIA Attack Management

Please refer to Chapter 9 for a discussion on the etiology, clinical features, and management of an acute TIA attack.

TIA-Associated Suggested Dental Management Guidelines

The following are dental guidelines for TIA:

1. TIA patients could be on any one of the following blood thinners: aspirin, dipyridamole (Persantine), clopidogrel (Plavix), or warfarin (Coumadin). Always consult with the MD to determine whether the drug or drugs can be temporarily discontinued prior to major surgery. When possible, Coumadin is usually stopped 48 hours prior to treatment and restarted the evening of the surgery or the next day. The restart time depends on when the patient typically takes the warfarin (Coumadin). Aspirin, dipyridamole (Persantine), and clopidogrel (Plavix), when approved for stopping, can be typically stopped seven days prior to treatment and restarted 1–2 days post operatively. Currently, most physicians are reluctant />

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Jan 4, 2015 | Posted by in General Dentistry | Comments Off on 23: Cerebral Circulation Diseases TIAs and CVAs: Assessment, Analysis, and Associated Dental Management Guidelines

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