• Transient Ischemic Attack (TIA)

Transient Ischemic Attack (TIA)
A transient ischemic attack is a brief focal neurologic deficit that resolves without any permanent
neurologic impairment. Most cases are due to a small cerebral embolism or transient thrombosis
(clotting) of a cerebral or carotid artery in an individual with underlying atherosclerotic disease. Others
may be caused by emboli from the heart or elsewhere in the vascular system. An attack may last for a
few minutes or a few hours, but ultimately it disappears without any residual neurologic impairment.
Symptoms and signs such as numbness, weakness, dizziness, fainting, vision defects or aphasia
(difficulty with speech) are typical of TIA and usually lead to the diagnosis. However, because of the
fleeting nature of attacks, the physician's diagnosis is made in most cases from history alone, rather than
by physical exam or laboratory testing. Follow-up testing, such as carotid studies and head CT or MRI
scans may reveal evidence of atherosclerotic disease or previous stroke. These tests cannot rule out
that a TIA occurred.
Amaurosis fugax is a term for temporary monocular (one eye) or partial blindness, lasting ten minutes or
less. Amaurosis fugax is a form of a transient ischemic attack.
The incidence of transient ischemic attacks is much greater in the elderly. The underwriting significance
relates to the fact that affected persons are at an increased risk of stroke. If untreated, one-third will go
on to a completed stroke, one-third will have further TIAs, and one-third will have no further problems.
Early mortality following a transient ischemic attack tends to be high, with deaths occurring from both
stroke and coronary heart disease (heart attack). If atherosclerotic lesions are present in multiple
cerebral arteries or if there has been a history of multiple episodes of transient ischemic attacks, the risk
is increased.
Medical treatment may include the use of anticoagulants (blood thinners such as aspirin or Coumadin)
and artery dilators. Surgical treatment may be used to enlarge an obstructed artery (endarterectomy) or
to bypass the obstruction with a graft. Blood pressure control is vital.
Underwriting considerations for an applicant with history of a transient ischemic attack:
Single episode Age at diagnosis
< 55 years old 55+ years old
0-6 years Table D Table C
7-10 years Table C Table B
After 10 years Non-rated Non-rated
Multiple episodes Table F Table E
Uncontrolled hypertension, diabetes and cholesterol increase the risk associated with transient ischemic
attacks and will increase the overall rating.
To get an idea of how a client with a TIA history would be viewed in the underwriting process, feel free to
use the Ask “Rx” pert underwriter on the reverse side for an informal quote.
This material is intended for insurance informational purposes only and is not personal medical advice for clients.
This marketing material includes an expiration date and use of this material must be discontinued as of the expiration date.
FOR INTERNAL USE ONLY. NOT FOR USE WITH THE PUBLIC
©2005 The Prudential Insurance Company of America
751 Broad Street, Newark, NJ 07102-3777
Rx016 IFS-A005232 Ed. 09/05 Exp. 03/07
 TIA - Ask "Rx" pert underwriter
(ask our experts)
Producer _______________________ Phone _______________ FAX ______________
Client _________________________ Age/DOB _____________ Sex ______________
If your client has had a Transient Ischemic Attack, please answer the following:
1. Please list date(s) of the TIA(s) _________________________________________
2. Were any of the following studies completed?
carotid ultrasound ___________________(date)
head CT scan or MRI scan ____________(date)
echocardiogram _____________________(date)
3. Is your client on any medications?
yes, please give details ________________________________________
no
4. Please check if your client has had any of the following:
elevated cholesterol stroke
diabetes heart attack
high blood pressure peripheral vascular disease
coronary artery disease
5. Has your client smoked cigarettes in the last 12 months?
yes
no
6. Has surgery ever been done on the carotid artery(ies)?
yes, please give details ________________________________________
no
7. Please give the date and result of the most recent blood pressure reading:
___________________________________________________________________
8. Does your client have any other major health problems (ex: cancer, etc.)?
yes, please give details _________________________________________
no
After reading the Rx for Success on TIA, please feel free to use this Ask “Rx” pert underwriter for an
informal quote.
This material is intended for insurance informational purposes only and is not personal medical advice for clients.
This marketing material includes an expiration date and use of this material must be discontinued as of the expiration date.
FOR INTERNAL USE ONLY. NOT FOR USE WITH THE PUBLIC
©2005 The Prudential Insurance Company of America
751 Broad Street, Newark, NJ 07102-3777
Rx016 IFS-A005232 Ed. 09/05 Exp. 03/07