differentiation of true transient ischemic attack versus transient ischemic attack mimics.

background: previous literatures have shown a transient ischemic attack  (tia) mimic rate  of 9-31%. we aimed  to ascertain the proportion of stroke mimics amongst suspected tia patients. methods: a prospective observational study was performed in   ghaem   hospital,   mashhad,   iran   during   2012-2013. consecutive tia patients  were identified in a stroke center. the  initial diagnosis  of tia  was made  by the  resident  of neurology and final diagnosis of true tia versus tia mimics was made after 3 months follow-up by stroke subspecialist. results: a total of 310 patients  were assessed  during a 3- month period of which 182 (58.7%) subjects were male and 128 (41.3%) were female. ten percent  of the patients  was categorized  as a tia mimic. the presence  of hypertension, aphasia, duration of symptoms, and increased age was the strongest predictor  of a true  tia. migraine was the  most common etiology of stroke mimic in our study. conclusion:  it  seems  that  many  signs  and  symptoms have low diagno tic  usefulness for discrimination of true tia from non-cerebrovascular events and predictive usefulness of any sign or symptom should be interpreted by a stroke neurologist.