| Transient ischemic attack patients with fluctuations are at highest risk for early stroke. | |
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MedLine Citation:
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PMID: 19390186 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The management and risk of early stroke are unclear in patients with fluctuating neurological symptoms. We aimed to evaluate the clinical course of these patients presenting within 24 h after onset of acute cerebral ischemia symptoms. METHODS: All patients with transient ischemic signs/symptoms consecutively admitted to our Emergency Stroke Unit were recruited. Patients were neurologically examined and underwent prompt CCT plus MRI imaging for visualization of early signs of ischemia. RESULTS: Among 122 patients, 84 (69%) had single symptoms, 33 (27%) showed rapidly relapsing and remitting symptoms - in 5 cases (4%) symptom duration could not reliably be assessed. 11/122 (9%) suffered a stroke during hospitalization. ABCD(2) scores did not predict early strokes: 2/11 (18.2%) were in the 'lower risk', 7/11 (63.6%) in the 'moderate risk' and only 2/11 (18.2%) in the 'high risk' group (p = 0.103). 3/11 patients (27.3%) revealed lesions in neuroimaging, but surprisingly 8/11 (72.7%, p = 0.132) did not. However, patients with fluctuations in neurological status were significantly more likely to suffer a stroke: 9/122 versus 2/122 with stable symptoms (p < 0.05). Patients with small vessel disease were common in all (53/ 122; 43.4%) and within those who suffered an early stroke (6/11; 54.5%). CONCLUSIONS: Patients with unstable transient ischemic attacks immediately after onset of clinical symptoms are at high risk for subsequent stroke - they may benefit from Stroke Unit management and potential early thrombolysis once they develop strokes. |
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Authors:
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Anastasios Chatzikonstantinou; Olaf Willmann; Theo Jäger; K Szabo; Michael G Hennerici |
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Publication Detail:
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Type: Journal Article Date: 2009-04-24 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 27 ISSN: 1421-9786 ISO Abbreviation: Cerebrovasc. Dis. Publication Date: 2009 |
Date Detail:
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Created Date: 2009-05-29 Completed Date: 2009-09-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: Switzerland |
Other Details:
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Languages: eng Pagination: 594-8 Citation Subset: IM |
Affiliation:
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Department of Neurology, Universitätsklinikum Mannheim, Ruprecht-Karls-Universität Heidelberg, Mannheim, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Aged, 80 and over Blood Pressure / physiology Cerebral Arteries / ultrasonography Female Humans Ischemic Attack, Transient / complications*, diagnosis, physiopathology* Magnetic Resonance Angiography Magnetic Resonance Imaging Male Middle Aged Prospective Studies Recurrence Risk Factors Stroke / epidemiology* Time Factors Ultrasonography, Doppler |
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