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Related Experiment Videos

Predictive values of lacunar transient ischemic attacks.

Dominique Hervé1, Marion Gautier-Bertrand, Julien Labreuche

  • 1Department of Neurology and Stroke Center, Bichat University Hospital and Medical School, Denis Diderot University, Paris, France.

Stroke
|May 1, 2004
PubMed
Summary

Transient ischemic attacks (TIAs) preceding lacunar syndrome significantly increase the likelihood of lacunar brain infarction (BI). This suggests TIAs may indicate different underlying mechanisms for lacunar BI, especially in hypertensive patients.

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Area of Science:

  • Neurology
  • Cerebrovascular Diseases
  • Stroke Etiology

Background:

  • Lacunar brain infarction (BI) is often associated with small artery disease.
  • The clinical presentation of lacunar syndromes can vary, impacting diagnostic prediction.
  • Differentiating lacunar BI based on symptom onset and preceding transient ischemic attacks (TIAs) is crucial.

Purpose of the Study:

  • To investigate whether lacunar syndromes with TIAs or nonsudden onset predict lacunar BI more accurately than those with sudden onset.
  • To differentiate lacunar BI mechanisms based on clinical presentation.

Main Methods:

  • Analysis of 510 patients with BI, classified into etiologic groups including lacunar BI.
  • Identification of patients with lacunar or nonlacunar syndromes.

Related Experiment Videos

  • Assessment of TIAs preceding BI and symptom onset patterns (sudden vs. nonsudden).

    • Main Results:

    • Nonlacunar syndrome had a 95% negative predictive value for lacunar BI.
    • Lacunar syndrome had a 57% positive predictive value (PPV) for lacunar infarction.
    • PPV for lacunar infarction increased to 79% when preceded by recent TIAs.
    • Hypertension was present in 95% of lacunar TIA cases (OR: 10.69, P=0.02).

    Conclusions:

    • Lacunar TIAs are strongly associated with arterial hypertension and have a high PPV for lacunar BI.
    • Patients with lacunar TIAs may represent a distinct subgroup with different underlying mechanisms compared to those with sudden-onset lacunar syndromes.