Neuroscience Institute

Sarah Hermanson, ARNP and Nancy Isenberg, MD, with patient
   Within 24 to 48 hours of referral, Sarah Hermanson, ARNP (left) and neurologist Nancy Isenberg, MD, meet with patients who have suffered a transient ischemic attack (TIA), sometimes called a mini-stroke.

Rapid Access TIA Clinic Reduces Risk of Stroke

What if you suddenly experienced a stroke symptom — weakness, slurred speech, a change in vision or numbness in your body — that completely disappeared after a few minutes? You may have just suffered a transient ischemic attack (TIA), sometimes called a mini- stroke or warning stroke in which the blood supply to part of the brain is cut off for a brief period.

While TIAs resolve without causing permanent damage, about one in three people who have a TIA will eventually have a stroke, the fifth biggest killer in the U.S. and a top cause of long-term disability. The Rapid Access TIA Clinic, part of the Neuroscience Institute at Virginia Mason, provides fast, comprehensive treatment designed to reduce stroke risk in patients who have had a TIA — all without admission to the hospital.

“Low-risk TIA patients can be well cared for in our Rapid Access TIA Clinic, following the appropriate diagnostic work-up,” says neurologist Nancy Isenberg, MD, medical director, Rapid Access TIA Clinic. “A TIA is a warning sign and we need to act quickly to reduce stroke risk. By seeing these patients in our specialized clinic, we have a real opportunity to substantially impact risk.”

The Rapid Access TIA Clinic combines both medical and lifestyle interventions known to reduce stroke risk, at a time when patients are often motivated to make a change.

Many Rapid Access TIA Clinic patients are referred from the Emergency Department, after a diagnostic protocol determines who can be effectively managed in the outpatient setting. Primary care providers, whose patients report TIA symptoms, can arrange for an expedited appointment in the clinic as well. Patients are seen within 24 to 48 hours of referral by a neurology advanced registered nurse practitioner (ARNP), with access to any needed diagnostic tool, including MRI/CT scanning, advanced imaging of the arteries, ultrasound, heart studies and a full examination of an individual’s risk factors.

The Rapid Access TIA Clinic combines both medical and lifestyle interventions known to reduce stroke risk, at a time when patients are often motivated to make a change. Medications to lower blood pressure and cholesterol and prevent blood clots can be prescribed, and are shown in studies to drastically cut the risk of stroke. But lifestyle changes are given equal weight. Patients receive support to quit smoking, eat a healthier diet and find a form of exercise that works for them. Good control of conditions like diabetes and sleep apnea also help to improve vascular health.

Because creating new, healthy habits is difficult for many people, the Rapid Access TIA Clinic will soon introduce group visits, where patients can share experiences and learn from others on the same health improvement journey.

“It’s easy to prescribe medications after a TIA, but we also want to use the opportunity to educate patients,” says Sarah Hermanson, ARNP, Neuroscience Institute. “The sooner we can initiate prevention measures, the better our chances for creating lasting change.”