These congenital lesions can rupture at any age, but typically present in middle adult years. Most victims are healthy adults. Neurological exam is non-focal and CT is usually normal.
Timely diagnosis leads to life-saving surgical clipping.
There can be no routine, standard evaluation of patients with TIA or stroke because the individual medical history and specific characteristics of the event influence the optimal sequence and extent of diagnostic testing. For example, evaluation of an elderly hypertensive man who has multiple episodes of unilateral amaurosis fugax should focus immediately on the ipsilateral carotid artery. In contrast, a young woman with a history of spontaneous abortions, venous thrombosis, and multi-focal stroke should be assessed initially for antiphospholipid antibodies. A step-wise approach tailored to specific symptoms and associated illness is required. This slide outlines a general approach.