Transient ischemic attack with infarction: a unique syndrome?

It is debated whether transient symptoms associated with infarction (TSI) are best considered a minor ischemic stroke, a subtype of transient ischemic attack (TIA), or a separate ischemic brain syndrome. We studied clinical and imaging features to establish similarities and differences among ischemi...

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Publicado en:Annals of Neurology Vol. 57; no. 5; pp. 679 - 687
Autores principales: Ay H, Koroshetz WJ, Benner T, Vangel MG, Wu O, Schwamm LH, Sorensen AG
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell May2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2005
      vid: 57
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Transient ischemic attack with infarction: a unique syndrome?
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          Ay H
          Koroshetz WJ
          Benner T
          Vangel MG
          Wu O
          Schwamm LH
          Sorensen AG
        affil: AA Martinos Center for Biomedical Imaging and Stroke Service, Department of Neurology and Radiology, Massachusetts General Hospital, CNY149-2301, Charlestown, MA 02129; hay@partners.org
      sug:
        subj:
          Cerebral Ischemia, Transient Physiopathology
          Acute Disease
          Aged
          Case Control Studies
          Cerebral Ischemia, Transient Risk Factors
          Comorbidity
          Data Analysis, Statistical
          Descriptive Statistics
          Female
          Funding Source
          Male
          Massachusetts
          Time Factors
          Human
          Aged: 65+ years
          Female
          Male
      ab: It is debated whether transient symptoms associated with infarction (TSI) are best considered a minor ischemic stroke, a subtype of transient ischemic attack (TIA), or a separate ischemic brain syndrome. We studied clinical and imaging features to establish similarities and differences among ischemic stroke, TIA without infarction, and TSI. Eighty-seven consecutive patients with TIA and 74 patients with ischemic stroke were studied. All underwent diffusion-weighted imaging on admission. Symptom duration and infarct volume were determined in each group. Thirty-six patients (41.3%) with TIA had acute infarct(s). Although TIA-related infarcts were smaller than those associated with ischemic stroke (mean, 0.7 vs 27.3 ml; p < 0.001), there was no lesion size threshold that distinguished ischemic stroke from TSI. In contrast, the symptom duration probability density curve was not broad, but instead peaked early with only a few patients having symptoms for longer than 200 minutes. The probability density function for symptom duration was similar between TIA with or without infarction. The in-hospital recurrent ischemic stroke and TIA rate was 19.4% in patients with TSI and 1.3% in those with ischemic stroke. TIA with infarction appears to have unique features separate from TIA without infarction and ischemic stroke. We propose identifying TSI as a separate clinical syndrome with distinct prognostic features.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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