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PubMed2004

Epidemiology of transient ischemic attack and ischemic stroke in patients with underlying cardiovascular disease.

It is estimated that 15 to 30% of ischemic strokes are cardioembolic in origin, and that atrial fibrillation, valvular heart disease, coronary artery disease, congestive heart failure, and myocardial infarction are significant risk factors for stroke, which underscores the importance for cardiologists to understand this condition. The high incidence and substantial cost of stroke justify aggressive treatment of stroke risk factors, especially in the elderly, diabetic, and black populations, and in patients who have had an initial stroke. Antiplatelet therapy and administration of oral anticoagulants have both been shown to have a substantial impact on stroke in specified populations at risk.

Age Factors↗
PubMed1978

The role of platelets in transient ischemic attacks and cerebral vascular accidents.

In a 5 1/2-year study in 585 patients, aspirin, 1200 mg/day, reduced 50% the risk of stroke or death in men who had experienced at least one episode of neurological disability in carotid or vertebral-basilar territory. Adding sulfinpyrazone to aspirin did not improve the results, and sulfinpyrazone alone was no better than placebo. Women did not experience the same benefit; aspirin did not reduce their risk of stroke or death.

Aspirin↗
PubMed1993

Factors causing prolonged hypoperfusion after transient ischemic attack.

Even during the symptom-free stages, patients with a TIA often experience cerebral blood flow disturbances. In order to evaluate the factors which cause this abnormality, we studied the cerebral blood flow disturbance, anatomy and clinical status in 21 patients after TIAs. The results of 99mTc-hexamethyl-propylene-amine oxime SPECT were compared with CT, cerebral angiogram, cerebrovascular risk factors and clinical findings to determine which factor is most responsible for the hypoperfusion of brain after TIA. The overall sensitivity rates in detecting a lesion were 67% in SPECT and 19% in CT. The hypoperfused area tended to be large in patients who had intracranial, severe stenotic, multiple, or hemodynamically significant arterial lesions on the ipsilateral side. No such relationships were found between other examinations. We conclude that hypoperfusion after TIA essentially reflects a continuous cerebral blood flow disturbance that can be attributed to atherosclerosis of the cerebral arteries, with subsequent embolic and/or hemodynamic cerebral ischemia, although there may be a variety of processes.

Adult↗