Predicting and preventing stroke after transient ischemic attack.
The prognosis of transient ischemic attacks (TIAs) is not as favorable as previously thought. Given a risk of stroke of approximately 10% in the first week following a TIA, urgent evaluation and initiation of treatment are required. Recently developed scores to predict the early risk of subsequent stroke in individual patients may guide treatment decisions in the acute phase. Lately it has become clear that transient attacks with nonfocal symptoms are not benign either, as these were found to be associated with an increased risk of vascular disease. The significance of this finding and its implications for treatment are not yet clear. There is substantial evidence from a number of clinical trials that adequate secondary prevention therapies can reduce the risk of stroke after TIA. In addition to the conventional vascular risk factors, interest has grown in less strong but more prevalent lifestyle factors, but trials evaluating the effect of modifying these factors are as yet lacking.
de Lau
Lonneke M L
LM
Department of Neurology, Erasmus Medical Center, Rotterdam, 3000 CA Rotterdam, The Netherlands. l.delau@erasmusmc.nl
den Hertog
Heleen M
HM
van den Herik
Evita G
EG
Koudstaal
Peter J
PJ
D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics / Q000517:prevention & control*
D010975:Platelet Aggregation Inhibitors