From the Guidelines
Cervical spine 2 views imaging is not indicated in the routine evaluation of transient ischemic attack (TIA). The primary goal of imaging in TIA is to identify potential sources of emboli or areas of stenosis in the cerebrovascular system, which is achieved through brain imaging (CT or MRI) and vascular assessment (carotid ultrasound, CT angiography, or MR angiography) 1. Cervical spine radiographs are used to evaluate for structural abnormalities, fractures, or degenerative changes of the cervical vertebrae, but they do not provide relevant information about the cerebrovascular event that characterizes a TIA.
Some key points to consider in the evaluation of TIA include:
- The high risk of subsequent stroke after a TIA, with a 90-day risk of 11.6% 1
- The importance of expeditious initial imaging to identify potential sources of emboli or areas of stenosis in the cerebrovascular system 1
- The use of vascular imaging, such as carotid ultrasound, CT angiography, or MR angiography, to evaluate the cervical carotid arteries and identify potential sources of emboli or areas of stenosis 1
- The focus of the diagnostic approach for TIA on identifying the underlying cause of the temporary neurological deficit, which typically involves assessment of cerebral circulation rather than cervical spine structures 1
In specific cases where there is neck trauma, suspected cervical spine instability, or symptoms suggesting cervical radiculopathy concurrent with TIA symptoms, cervical spine imaging might be considered, but it is not part of the standard TIA workup. The most recent and highest quality study, published in 2024, supports the use of brain imaging and vascular assessment in the evaluation of TIA, without recommending cervical spine imaging 1.
From the Research
Cervical Spine 2 Views in TIA
- The provided studies do not directly address the indication of Cervical Spine 2 Views in Transient Ischemic Attack (TIA) diagnosis or management 2, 3, 4, 5, 6.
- However, the studies emphasize the importance of neuroimaging, cervicocephalic vasculature imaging, and cardiac evaluation in the diagnosis and management of TIA 2, 3, 4, 5, 6.
- Cervical spine imaging may be relevant in certain cases where there is suspicion of cervical artery dissection or other cervical spine-related conditions that may mimic or contribute to TIA symptoms 4.
- The decision to perform Cervical Spine 2 Views or other imaging studies should be based on individual patient presentation and clinical judgment, taking into account the patient's symptoms, medical history, and risk factors for stroke or other conditions 3, 5, 6.