title: [Diagnostic lessons of recurrence pattern after transient ischemic attacks].
abstract: OBJECTIVE
  Early stroke recurrence risk alter a transient ischemic attack (TIA) is high. We studied the diagnostic implications of the recurrence pattern after TIA.
  
  
  METHODS
  210 consecutive TIA patients were studied. Ultrasonographic (US), neuroimaging and cardiologic data were collected.
  
  
  RESULTS
  At 90 day follow-up, 14 patients (6.7%; 95% CI: 3.3-10.1) among 209 suffered an ischemic infarction (II), 9 (4.3%; 1.5-7.1) a TIA and 6 (2.9%; 0.6-5.1) a cardiac ischemic event. Moreover, 13 patients (6.2%; 2.8-9.6) among 210 with a seven-day follow-up had an II. Multivariate analyses only identified the presence of intracranial stenoses (HR, 23.29; 95% CI, 3.49 to 23.57; p<0.018) as independent predictors of stroke within the first 7 days, and large-artery occlusive disease (HR, 9.07; CI, 3.49 to 23.57; p<0.001) as a predictor of stroke recurrence at 90 day follow-up. A new diagnosis of atrial fibrillation was observed in 21 subjects (10.0%), and it was documented in the baseline ECG in 62% cases. Acute diffusion abnormalities were identified in 81 (44,5%) of 182 patients, and chronic ischemic lesions were observed in 110 (60.4%) on MRI vs 56 (26.7%) among 210 on CT scan.
  
  
  CONCLUSIONS
  Due to very early recurrence, the routine use of ultrasonography within the first hours after an index TIA will be useful to identify those patients at high risk. The prognostic usefulness of diffusion-weighted studies will be only achieved if it is performed early. Routine noninvasive cardiac rhythm monitoring has a low detection rate.
authors: Sección de Neurología, Unidad de Ictus, Hospital Universitari Arnau de Vilanova de Lleida, Universitat de Lleida, IRBLLEIDA, Lleida, España. fpurroygarcia@gmail.com
authors: Francisco
authors: F
authors: Purroy
authors: Robert
authors: R
authors: Begué
authors: Alejandro
authors: A
authors: Quílez
authors: Gerard
authors: G
authors: Piñol-Ripoll
authors: Jordi
authors: J
authors: Sanahuja
authors: Luis
authors: L
authors: Brieva
authors: Eloisa
authors: E
authors: Setó
authors: Maria Isabel
authors: MI
authors: Gil
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000175:diagnosis; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography