When is angiography typically indicated in patients with transient ischemic attacks?

Angiography is typically indicated in cases of multiple transient ischemic attacks (TIAs) because these recurrent events suggest an underlying vascular problem that may require further investigation. TIAs are temporary episodes of neurological dysfunction due to a lack of blood flow to the brain, and having multiple TIAs raises the concern for a significant risk of future strokes.

Performing angiography in such situations allows healthcare professionals to visualize the blood vessels in the brain and neck, helping to identify any blockages or abnormalities that could be contributing to these transient events. By identifying the underlying cause of the TIAs, it becomes possible to implement appropriate preventive measures, which could include medical management or surgical interventions.

In cases where only a single TIA occurs or where symptoms are mild, the necessity for angiography may not be as pressing, as the risks associated with the procedure might outweigh the benefits. Emergencies, while significant, typically relate to acute management decisions rather than initial evaluation and diagnosis, further underscoring why multiple TIAs specifically warrant angiography.