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[Not every TIA is primarily vascular].

H J Gilhuis1, A C Kappelle, J W Swen

  • 1Reinier de Graaf Ziekenhuis, afd. Neurologie, Reinier de Graafweg 3-11, 2625 AD Delft. gilhuis@rdgg.nl

Nederlands Tijdschrift Voor Geneeskunde
|October 7, 2003
PubMed
Summary

Brain tumors can cause transient neurological deficits mimicking a transient ischemic attack (TIA). Early brain imaging, particularly MRI, is crucial for accurate diagnosis and distinguishing tumors from vascular events.

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Area of Science:

  • Neurology
  • Oncology

Background:

  • Transient neurological deficits can be caused by various conditions, including vascular events and brain tumors.
  • Differentiating between transient ischemic attacks (TIAs) and neurological symptoms caused by tumors is clinically challenging.

Observation:

  • Three patients with brain tumors (glioblastoma multiforme and meningiomas) presented with transient neurological deficits.
  • A fourth patient experienced a TIA with an incidentally discovered meningioma.
  • Symptoms included motor loss, sensory disturbances, dysphasia, and dysarthria, lasting seconds to minutes.

Findings:

  • Brain tumors account for 0.4-1% of patients presenting with TIA-like symptoms.
  • Transient tumor attacks are most common with meningiomas and high-grade gliomas.

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  • Intracranial pressure changes leading to focal ischemia may explain these transient symptoms.

    • Implications:

    • Clinical presentation alone cannot reliably distinguish transient tumor attacks from TIAs.
    • Brain imaging, especially MRI, is essential for diagnosing neurological deficits.
    • Non-vascular mimics of TIA include demyelinating diseases, metabolic disturbances, epilepsy, and migraine.