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Transient ischemic attacks before ischemic stroke: preconditioning the human brain? A multicenter magnetic resonance
Susanne Wegener1, Barbara Gottschalk, Verica Jovanovic
1Department of Neurology, University Hospital Charité, Schumannstrasse 20/21, 10117 Berlin, Germany. susanne.wegener@charite.de
Stroke
|February 14, 2004
Summary
Transient ischemic attacks (TIAs) may protect the brain. Patients with a history of TIAs had smaller stroke lesions and milder deficits, suggesting endogenous neuroprotection.
Area of Science:
- Neuroscience
- Neurology
- Cerebrovascular Disease
Background:
- Transient ischemic attacks (TIAs) are warning signs for stroke.
- The potential for TIAs to induce protective brain tolerance is not fully understood.
Purpose of the Study:
- To investigate if preceding TIAs can induce neuroprotection in the human brain.
- To determine if TIAs raise the threshold for tissue vulnerability during stroke.
Main Methods:
- Sixty-five patients with first-ever ischemic stroke underwent diffusion- and perfusion-weighted MRI.
- Comparison of lesion volumes, apparent diffusion coefficient (ADC) maps, and cerebral blood flow/volume between patients with and without prodromal TIAs.
Main Results:
- Patients with a history of TIAs had smaller initial diffusion lesions.
- Final infarct volumes were significantly reduced in patients with TIAs (9.1 mL vs. 36.5 mL).
- Milder clinical deficits were observed in patients with a history of TIAs.
Conclusions:
- TIAs demonstrate a beneficial effect on reducing acute ischemic stroke lesion size.
- Findings suggest the presence of endogenous neuroprotective mechanisms in the human brain activated by TIAs.