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Related Experiment Videos

Transient ischemic attack with infarction: a unique syndrome?

Hakan Ay1, Walter J Koroshetz, Thomas Benner

  • 1Department of A. A. Martinos Center for Biomedical Imaging and Stroke Service, Department of Radiology, Boston, MA 02129, USA. hay@partners.org

Annals of Neurology
|April 27, 2005
PubMed
Summary
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Transient symptoms associated with infarction (TSI) present unique features, differing from transient ischemic attack (TIA) and ischemic stroke. These findings suggest TSI may be a distinct clinical syndrome with unique prognostic indicators.

Area of Science:

  • Neurology
  • Cerebrovascular Diseases
  • Neuroimaging

Background:

  • The classification of transient symptoms associated with infarction (TSI) remains debated, with uncertainty regarding its relationship to minor ischemic stroke, transient ischemic attack (TIA), or a distinct ischemic brain syndrome.
  • Understanding the clinical and imaging distinctions between ischemic stroke, TIA without infarction, and TSI is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the clinical and imaging characteristics of patients with transient ischemic attack (TIA) and ischemic stroke.
  • To differentiate transient symptoms associated with infarction (TSI) from TIA without infarction and ischemic stroke based on symptom duration and infarct volume.
  • To evaluate the in-hospital recurrence rates of ischemic events in these patient groups.

Main Methods:

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  • Prospective study of 87 patients with TIA and 74 patients with ischemic stroke.
  • All patients underwent diffusion-weighted imaging (DWI) on admission.
  • Analysis of symptom duration, infarct volume, and in-hospital recurrence rates.

Main Results:

  • Thirty-six percent of TIA patients (41.3%) exhibited acute infarcts on DWI, termed TSI.
  • TIA-related infarcts were significantly smaller than those in ischemic stroke patients (0.7 mL vs. 27.3 mL).
  • No specific lesion size threshold differentiated ischemic stroke from TSI. Symptom duration patterns were similar between TIA with and without infarction.
  • In-hospital recurrence rates were higher in patients with TSI (19.4%) compared to ischemic stroke (1.3%).

Conclusions:

  • Transient symptoms associated with infarction (TSI) exhibit unique clinical and imaging features.
  • TSI appears distinct from both TIA without infarction and established ischemic stroke.
  • The study proposes classifying TSI as a separate clinical syndrome with specific prognostic implications.