Predictors of cerebral infarction following transient ischemic attack.
Transient ischemic attack (TIA) is a warning sign for impending cerebral infarction, mainly within several months following the attack. To determine if any clinical characteristics could prognosticate cerebral infarction following a TIA, we studied and followed 68 consecutive patients who presented with a TIA. We determined the vascular risk factors, frequency, duration, vascular territory involved, and presumed etiology of the attacks. Diagnostic tests and treatment were individualized. Follow-up ranged from 1 day to 36 months (mean, 19 months). Four patients died from non-neurologic causes without having had a stroke. Cerebral infarction occurred in five patients (7%), 6 hours, 1 day, 10 days, 5 months, and 14 months after the presenting TIA. Two clinical characteristics were associated with a significantly increased risk of cerebral infarction: diabetes mellitus (p < 0.001) and history of multiple TIAs > 1/month at the time of presentation (p = 0.005). Patients presenting with a recent TIA and these risk factors may benefit from more aggressive treatment.
From the Neurology Service, Veterans Affairs Medical Center, and the Department of Neurology, University of New Mexico, Albuquerque, NM, U.S.A.
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Bruno
From the Neurology Service, Veterans Affairs Medical Center, and the Department of Neurology, University of New Mexico, Albuquerque, NM, U.S.A.
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Jeffries
From the Neurology Service, Veterans Affairs Medical Center, and the Department of Neurology, University of New Mexico, Albuquerque, NM, U.S.A.
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LaKind
Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, U.S.A.
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Qualls