SEARCH · PubMed Health

Results for “Transient ischemic attack”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed2004

Evaluation and management of transient ischemic attack and minor cerebral infarction.

After immediate intervention for cerebral infarction or transient ischemic attack (TIA), the primary goal is secondary prevention of future cerebral ischemia and prevention of complications related to the initial ischemic event. The goals of the diagnostic evaluation are to (1) determine potential contributing mechanisms (cardioembolic, large-vessel disease of the extracranial and intracranial vessels, small-vessel disease, coagulation defects, and cryptogenic), (2) identify contributing risk factors (hypertension, hyperlipidemia, tobacco use, diabetes), and (3) complete the evaluation in a cost-effective and safe manner. We provide a sequential approach to the diagnostic evaluation of cerebral infarction or TIA to optimize diagnostic yield of testing, minimize cost and potential harm to the patient, and provide information that will change management. This systematic approach focuses on 6 important questions: (1) Are the symptoms consistent with a cerebral infarction or TIA (versus nonischemic pathology)? (2) Where does the ischemic event localize? (3) What etiologies and mechanisms of cerebral infarction and TIA are possible? (4) What is the prevalence of each potential etiology? (5) What treatments are available for this etiology? (6) What tests and studies are useful to evaluate this etiology?

Adult↗

PubMed1999

[Plasma homocysteine levels in patients with transient ischemic attacks].

OBJECTIVE: To evaluate plasma homocysteine (Hcy) levels in patients with atherotrombotic transient ischemic attacks (TIA), its temporal profile and response to folic acid (FA) treatment. PATIENTS AND METHODS: Hcy was determined in 62 patients and in 69 controls. RESULTS: There were no differences (p < 0.87) of baseline Hcy in TIA patients vs controls. Hcy levels were higher 4-6 weeks after TIA (p = 0.02). FA treatment decreases the Hcy levels (p < 0.00001). CONCLUSION: Hyperhomocisteinemia is a possible risk factor for atherothrombotic TIA and should be measured between 4-6 weeks after TIA. Treatment with FA normalizes Hcy levels.

Adult↗

PubMed1992

Transient ischemic attack (TIA) secondary to subdural hematoma.

Subdural hematomas many sometimes clinically resemble Transient Ischemic Attacks (TIA's). We present three cases which were initially evaluated for, diagnosed as having and were treated for TIA's, but later were found to have subdural hematomas. As in case one, patients with subdurals may have antecedent head trauma which they may or may not recall. Patients presenting with symptoms resembling TIA's need a complete neurologic evaluation. The differential diagnosis for TIA's includes arteriosclerotic extracranial vascular disease, cardiac emboli, migraine, seizure disorder, and mass lesions. Since the prognosis and treatment differs one needs to determine the etiology of the symptoms before treatment is initiated. Specifically, other diagnoses must be excluded prior to anticoagulation therapy, as evidenced by case 2.

Aged↗

PubMed1988

Transient ischemic attack: a complication of mitral valve prolapse in pregnancy.

A case of transient ischemic attack presumably due to cardiogenic thromboembolism during pregnancy is described in a 32-year-old woman. The patient had documented mitral valve prolapse which was uncomplicated until this episode. This is the first report in the literature of such a complication during pregnancy. The clinical management is described.

Adult↗

PubMed1996

Right ventricular nerve sheath tumour and patent foramen ovale presenting with transient ischemic attack.

A 66-year-old man presented with dyspnea and a transient ischemic attack. Echocardiography revealed a right ventricular mass and patent foramen ovale. During surgery the mass was found to be a malignant nerve sheath tumour. Several weeks later, the patient developed small bowel obstruction, and laparotomy disclosed multiple metastases involving the small and large bowel. The paper describes the clinical course and management of this patient and reviews the pertinent literature.

Aged↗

PubMed1996

Cerebral Embolism as a Cause of Stroke and Transient Ischemic Attack.

The most frequent cause of stroke and transient ischemic attacks is cerebral embolism. Cardiogenic cerebral embolization is common among patients with any cause of atrial fibrillation (AF) but particularly in AF resulting from rheumatic and arteriosclerotic heart disease. Rare causes of cerebral embolism include fat entering the bloodstream after trauma, tumor cells arising from atrial myxomata, and gas embolism. Cerebral embolic infarctions and their sources of origin can now be confirmed during life by many invasive (I) and noninvasive (NI) procedures including computerized tomography (CT) scanning (NI), magnetic resonance imaging (MR) (NI), contrast angiography (I), digital subtraction angiography (I), magnetic resonance angiography (NI), carotid Doppler and transcranial Doppler (NI), and echocardiography (NI) without and with contrast. These tests visualize the following: embolic occlusions of small and large cerebral arteries, resultant cerebral infarctions in appropriate vascular territories, plaques within the aorta, subclavian, vertebral, and carotid arteries, and mural thrombi located within the heart and aortocephalic arteries. Transcranial Doppler monitoring of the middle cerebral artery detects both small (asymptomatic) and large (symptomatic) cerebral emboli, as well as transseptal cardiac shunting, which is a cause of paradoxical embolization. Holter monitoring detects episodic cardiac dysrhythmias not apparent during routine ECG. CT or MRI identify cerebral infarctions resulting from virtually all large cerebral emboli. Early recognition and identification of types of cerebral embolism are important because of the availability of effective prophylactic therapies. (ECHOCARDIOGRAPHY, Volume 13, September 1996)

Journal Article↗

PubMed1986

Transient ischemic attacks at high altitude.

The precise etiology of transient neurologic deficits at high altitude is unclear, particularly since the subjects are not investigated as they would be had the events occurred in an urban environment. This report describes two subjects who experienced transient ischemic attacks (TIAs) while ascending the northeast ridge route of Mt. Everest during the Ultima Thule Everest Expedition, and a third subject with TIAs during three separate high-altitude climbs. Possible etiologies and treatment for TIAs at high altitude are suggested.

Adult↗

PubMedDate not supplied

Relationship of transient ischemic attacks and angiographically demonstrable lesions of carotid artery.

Eighty-eight percent of arteries in patients with amaurosis fugax or hemispheric transient ischemic attacks had angiographically demonstrable lesions at the carotid bifurcation. Eighty-one percent had stenoses or occlusions at the carotid bifurcation; 7 percent had ulcerative lesions without stenoses at this site. Forty-nine percent of arteries in these patients demonstrated ulcerative lesions with or without stenosis at the carotid bifurcation. There was no significant difference in the incidence or types of ulcerations between those patients with amaurosis fugax and those with hemispheric transient ischemic attacks. Eighty-eight percent of arteries examined in this series were amenable to surgical reconstruction. Amaurosis fugax and hemispheric transient ischemic attacks were of equal value in predicting the possibility of a surgically treatable lesion at the carotid bifurcation.

Blindness↗

PubMed1990

Cerebrospinal fluid lactate dehydrogenase levels in early stroke and transient ischemic attacks.

We examined the concentrations of lactate dehydrogenase in the cerebrospinal fluid of 25 patients with strokes and 15 patients with transient ischemic attacks less than or equal to 8 hours after the onset of the vascular event and in a control group of 21 patients. We found significantly higher concentrations in the stroke patients (40.9 +/- 14.5 units/l) than in the transient ischemic attack patients (11.8 +/- 2.9 units/l, p less than 0.001) and the controls (11.2 +/- 6.7 units/l, p less than 0.001). Among the stroke patients, we found a significantly higher lactate dehydrogenase concentration in those with cortical strokes (n = 12, 50 +/- 12.3 units/l) than in those with lacunar white matter infarcts (n = 5, 26.4 +/- 6.5 units/l; p less than 0.001) and those with basal ganglia infarcts (n = 8, 36.37 +/- 11.7 units/l; p less than 0.05). Our study offers a supplementary examination for diagnosing cortical or subcortical infarction during the early stage of the event, with the possibility of distinguishing precisely stroke from transient ischemic attack during the first hours after onset of the event.

Acute Disease↗

PubMed2002

Quantitative diffusion-weighted MR imaging in transient ischemic attacks.

BACKGROUND AND PURPOSE: The risk of stroke after a transient ischemic attack (TIA) is high. Appropriately directed therapies may reduce this risk. However, sensitive means of detecting the presence of subtle neuronal ischemia are lacking. We investigated the potential use of quantitative diffusion-weighted (DW) MR imaging in the detection of deficits produced by transient cerebral ischemia. METHODS: Twenty-eight patients who came to the stroke service from the emergency room of a tertiary teaching hospital with the final diagnosis of transient cerebral ischemia underwent conventional MR imaging, MR angiography, and DW MR imaging within 24 hours of presentation. Fifteen patients had normal conventional DW images confirmed by a staff neuroradiologist and neurologist. For these patients, absolute quantitative diffusion values were subsequently calculated for the clinically relevant brain region and were compared with the values calculated for the corresponding contralateral unaffected brain region. Thirteen patients had conventional DW images positive for lesions and were not studied. RESULTS: Quantitative DW imaging enabled detection of abnormal decreases (9-26%, P <.05) in the diffusion constant in brain regions suspected to be clinically involved by ischemia, when compared with the contralateral clinically unaffected brain tissue as well as with two other internal controls. CONCLUSION: Quantitative DW imaging depicts diffusion deficit in patients with TIA. Quantitative DW imaging may have better sensitivity compared with conventional DW imaging in detecting transient cerebral ischemia.

Adult↗

PubMed1997

We need stronger predictors of major vascular events in patients with a recent transient ischemic attack or nondisabling stroke. Dutch TIA Trial Study Group.

BACKGROUND: It has been proposed that most prognostic factors in patients with transient ischemic attack or nondisabling stroke are weak and consequently that patients at high risk of recurrent major vascular events cannot be reliably identified. METHODS: In the Dutch TIA trial, a multicenter, double-blind study of low-dose versus medium-dose aspirin, 3127 patients were included within 3 months after onset of a transient ischemic attack, amaurosis fugax, or nondisabling stroke. In a previous analysis, we developed a prediction model by means of Cox proportional hazards regression for the composite outcomes of fatal or nonfatal stroke and for myocardial infarction, stroke, or vascular death, based on clinical and demographic information as well as on the results of ancillary investigations. We assessed the discriminatory power and the calibration of the prediction models. RESULTS: The median numbers of prognostic factors for stroke, myocardial infarction, or vascular death outcome and for stroke alone were 3 and 4, respectively. The proportion of patients with a predicted probability exceeding 30% was less than 5% for both models; here the calibration of the models was poor. Only four of the patients with stroke, myocardial infarction, or vascular death were assigned a probability of greater than 50% for that outcome, and only one of the patients with stroke was given such a high probability. The models' discriminatory ability was a little disappointing (areas under the curve of 0.73 and 0.75, respectively). CONCLUSION: This analysis indicates that we need stronger predictors of recurrence risk in patients with a transient ischemic attack or nondisabling stroke.

Aged↗

PubMed2005

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 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.

Aged↗

PubMed1990

Transesophageal echocardiography in the detection of intracardiac embolic sources in patients with transient ischemic attacks.

Using both precordial and transesophageal echocardiography, we studied 72 consecutive patients with a recent unequivocal transient ischemic attack or nondisabling stroke to determine the relative value of the two techniques for detecting potential intracardiac sources of cerebral emboli. Group 1 (n = 53) patients had no clinical cardiac abnormality, and group 2 (n = 19) patients had abnormal cardiac findings upon clinical examination. In group 1, precordial echocardiography detected an abnormality in only one patient (aortic valve thickening) but transesophageal echocardiography defined morphologic abnormalities in five patients (one with a left atrial appendage mass lesion, one with aortic dissection, one with mitral valve prolapse, one with a mitral leaflet mass lesion, and one with aortic valve thickening). In group 2, both precordial and transesophageal echocardiographic studies were normal in 13 patients, while both were abnormal in the remaining six patients. Five of these six patients had pathologic left atrial and/or left ventricular dilatation, but only transesophageal echocardiography defined a left atrial appendage thrombus in two of the six. The sixth patient had mitral chordal rupture, seen on both precordial and transesophageal echocardiography. In addition, in 32 of the 72 patients transesophageal echocardiography identified widespread thoracic aortic atherosclerotic plaques not visualized by precordial echocardiography. We conclude that transesophageal echocardiography significantly increases the yield in visualizing potential intracardiac sources of emboli compared with precordial echocardiography. However, the precise clinical value of the former in the management of such patients requires further study as the number of abnormal transesophageal echocardiographic findings is not high and a causative relation with transient ischemic attacks cannot be proven.

Adult↗

PubMed1998

Right atrial metastatic melanoma in a patient with transient ischemic attacks.

A 65-year-old-man was admitted for evaluation of a transient ischemic attack. A 4.5 x 5.3-cm right atrial mass and a patent foramen ovale were identified by echocardiography. A 0.5-cm lesion was identified in the left temporal lobe of the brain by magnetic resonance imaging. Positron emission tomography was used to differentiate a tumor from an infarct in the brain. The cardiac and the brain lesions were successfully resected. Histopathologic study of the atrial and cerebral tissue demonstrated that these were metastases from a previously excised scalp desmoplastic malignant melanoma. The patient remains well at 14 months' follow-up.

Aged↗

PubMed2004

Stroke risk after transient ischemic attack in a population-based setting.

BACKGROUND AND PURPOSE: Stroke risk after transient ischemic attack (TIA) has not been examined in an ethnically diverse population-based community setting. The purpose of this study was to identify stroke risk among TIA patients in a population-based cerebrovascular disease surveillance project. METHODS: The Brain Attack Surveillance in Corpus Christi (BASIC) Project prospectively ascertains stroke and TIA cases in a geographically isolated Southeast Texas County. The community is approximately half Mexican American and half nonHispanic white. Cases are validated by board-certified neurologists using source documentation. Cumulative risk for stroke after TIA was determined using Kaplan-Meier estimates. Cox proportional hazards regression was used to test for associations between stroke risk after TIA and demographics, symptoms, risk factors, and history of stroke/TIA. RESULTS: BASIC identified 612 TIA cases between January 1, 2000, and December 31, 2002; 60.9% were female and 48.0% were Mexican American. Median age was 73.8 years. Stroke risk within 2 days, 7 days, 30 days, 90 days, and 12 months was 1.64%, 1.97%, 3.15%, 4.03%, and 7.27%, respectively. Stroke risk was not influenced by ethnicity, symptoms, or risk factors. CONCLUSIONS: Using a population-based design, we found that early stroke risk after TIA was less than previously reported in this bi-ethnic population of Mexican Americans and nonHispanic whites. Approximately half of the 90-day stroke risk after TIA occurred within 2 days.

Aged↗

PubMedDate not supplied

An epidemiologic study of cerebrovascular disease in western Japan: with special reference to transient ischemic attacks.

The prevalence and incidence ratios of cerebrovascular disease, with special reference to transient ischemic attack (TIA), were studied in the towns of Daisen and Ama in western Japan. There have been no previous reports on this subject in Japan. The prevalence ratios of TIA were estimated to be 4.4 in Daisen and 2.0 in Ama per 1,000 people over 40 years old. The ratio of carotid arterial system TIA to vertebrobasilar arterial system TIA was about 1 to 1. The incidence ratios of stroke were 319.6 in Daisen and 314.5 in Ama per 100,000 people of all ages. The prevalence ratios of stroke were estimated to be 14.8 in Daisen and 13.5 in Ama per 1,000 people of all ages. The prevalence ratio of TIA in Japan is about one-third to one-half of that in Western countries. However, the prevalence of complete stroke is much higher in Japan compared with that in Western countries. Therefore, the ratio of TIA to stroke is much lower in Japan than in Western countries. The obstruction of small intracranial arteries, in addition to heart disease, might play an important role in TIA in Japan, whereas in Western countries TIA might be mostly caused by heart disease or the atherosclerosis of extracranial arteries.

Adult↗

PubMedDate not supplied

Clinical and arteriographic comparison of amaurosis fugax with hemispheric transient ischemic attacks.

Eighty-seven patients with either amaurosis fugax (40 patients) or hemispheric transient ischemic attacks (47 patients) were studied to determine whether the two symptom groups could be differentiated clinically and arteriographically. Clinical data assessed were age of patient, incidence of cardiac disease, and presence of claudication, hypertension, diabetes, and carotid bruits. Contrary to a prior report, our results indicate no significant difference between the 2 patient groups based on clinical and arteriographic findings.

Adult↗

PubMed1992

[Clinical and experimental study of Ligusticum wallichii and aspirin in the treatment of transient ischemic attack].

This paper reports the results of the treatment of 158 cases with transient ischemic attack (TIA). They were randomly divided into Ligusticum wallichii group (111 cases) and Aspirin group (47 cases). The results showed that the total effective rate in Ligusticum wallichii group and in Aspirin group were 89.2% and 61.7% respectively. The effect of former on the treatment of TIA was superior to latter, and the difference between them was significant (P < 0.01). Experimental study showed that Ligusticum wallichii has the effects of increasing cerebral blood flow, accelerating the velocity of blood flow, dilating the spastic artery and decreasing peripheral arterial resistance. Both of them has the functions of decreasing the levels of thromboxane B2(TXB2), beta-thromboglobulin (beta-TG) and platelet factor IV (PF4) in plasma and increasing the concentration of 6-keto-prostaglandin F1 alpha (6 keto-PGF1 alpha) in plasma, the effect of Ligusticum wallichii was significantly better than Aspirin (P < 0.05).

Administration, Oral↗