title: Type of stroke after transient monocular blindness or retinal infarction of presumed arterial origin.
abstract: BACKGROUND
  Retinal infarction and transient monocular blindness (TMB) are associated with an increased risk of future ischaemic stroke. Little information is available on the type of subsequent ischaemic strokes that may occur (anterior or posterior circulation and small vessel or large vessel).
  
  
  OBJECTIVE
  To analyse the type of stroke after TMB.
  
  
  METHODS
  Patients with transient or permanent retinal ischaemia were selected from three prospective studies: the Dutch TIA Trial, the Dutch Amaurosis Fugax Study and the European/Australian Stroke Prevention in Reversible Ischaemia Trial. On follow-up the type of stroke was classified according to the supply territory and the type of vessel involved.
  
  
  RESULTS
  654 patients were included. During a mean follow-up of 5.2 years, 42 patients were found to have had a cerebral or retinal infarct, of which 27 occurred in the carotid territory ipsilateral to the symptomatic eye, 9 in the territory of the contralateral carotid artery and 6 were infratentorial strokes. Thirty patients had a large-vessel infarct, four had a small-vessel infarct and eight had a retinal infarct. Characteristics associated with a notable increased risk for subsequent stroke or retinal infarction were age > or = 65 years, a history of stroke, a history of intermittent claudication, diabetes mellitus, Rankin score > or = 3, more than three attacks of retinal ischaemia and any degree of ipsilateral carotid stenosis on duplex ultrasonography observation.
  
  
  CONCLUSIONS
  Ischaemic strokes after TMB or retinal infarction were found to be mainly large-vessel infarcts in the territory of the ipsilateral carotid artery. TMB and retinal infarction are probably manifestations of large-vessel disease.
authors.affiliation: Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, H.02.128, PO Box 85500, 3508 GA Utrecht, The Netherlands. e.deschryver@neuro.azu.nl
authors.forename: E L L M
authors.initials: EL
authors.lastname: De Schryver
authors.forename: A
authors.initials: A
authors.lastname: Algra
authors.forename: R C J M
authors.initials: RC
authors.lastname: Donders
authors.forename: J
authors.initials: J
authors.lastname: van Gijn
authors.forename: L J
authors.initials: LJ
authors.lastname: Kappelle
mesh_terms: D000368:Aged; D020757:Amaurosis Fugax / Q000150:complications* / Q000209:etiology; D002545:Brain Ischemia / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D007238:Infarction / Q000150:complications* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012160:Retina; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology