Background In the emergency room, distinguishing between a migraine with aura and a transient ischemic attack (TIA) is often not straightforward and mistakes can be harmful to both the patient and to society. To account for this difficulty, the third edition of the International Classification of Headache disorders (ICHD-3) changed the diagnostic criteria of migraine with aura. Methods One hundred twenty-eight patients referred to the emergency room at the University Hospital of Lübeck, Germany with a suspected TIA were prospectively interviewed about their symptoms leading to admission shortly after initial presentation. The diagnosis that resulted from applying the ICHD-3 and ICHD-3 beta diagnostic criteria was compared to the diagnosis made independently by the treating physicians performing the usual diagnostic work-up. Results The new ICHD-3 diagnostic criteria for migraine with aura and migraine with typical aura display an excellent specificity (96 and 98% respectively), and are significantly more specific than the previous ICHD-3 beta classification system when it comes to diagnosing a first single attack ( probable migraine with aura and probable migraine with typical aura). Conclusions The ICHD-3 is a highly useful tool for the clinical neurologist in order to distinguish between a migraine with aura and a TIA, already at the first point of patient contact, such as in the emergency department or a TIA clinic.

中文翻译：

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ICHD-3在诊断先兆偏头痛和典型先兆偏头痛方面比ICHD-3 beta更具特异性

背景 在急诊室，区分先兆偏头痛和短暂性脑缺血发作 (TIA) 通常并不容易，错误可能对患者和社会都有害。为了解决这个困难，国际头痛疾病分类（ICHD-3）的第三版改变了先兆偏头痛的诊断标准。方法 128 名被转诊至德国吕贝克大学医院急诊室的疑似 TIA 患者接受了前瞻性访谈，了解他们在初次就诊后不久就入院的症状。将应用 ICHD-3 和 ICHD-3 beta 诊断标准得出的诊断与由执行常规诊断检查的治疗医师独立做出的诊断进行比较。结果 新的 ICHD-3 先兆偏头痛和典型先兆偏头痛的诊断标准显示出极好的特异性（分别为 96% 和 98%），并且在诊断首次单次发作（有先兆的可能偏头痛和有典型先兆的可能偏头痛）。结论 ICHD-3 是临床神经学家非常有用的工具，用于区分先兆偏头痛和 TIA，已经在患者接触的第一个点，例如在急诊科或 TIA 诊所。并且在诊断第一次发作（可能有先兆的偏头痛和有典型先兆的可能偏头痛）方面比之前的 ICHD-3 beta 分类系统更加具体。结论 ICHD-3 是临床神经学家非常有用的工具，用于区分先兆偏头痛和 TIA，已经在患者接触的第一个点，例如在急诊科或 TIA 诊所。并且在诊断第一次发作（可能有先兆的偏头痛和有典型先兆的可能偏头痛）方面比之前的 ICHD-3 beta 分类系统更加具体。结论 ICHD-3 是临床神经学家非常有用的工具，用于区分先兆偏头痛和 TIA，已经在患者接触的第一个点，例如在急诊科或 TIA 诊所。