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Related Experiment Videos

Lacunar transient ischaemic attacks: a clinically useful concept?

G J Hankey1, C P Warlow

  • 1Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.

Lancet (London, England)
|February 9, 1991
PubMed
Summary

Transient ischaemic attacks (TIAs) show heterogeneity. Cortical TIAs link to carotid artery disease, while lacunar TIAs suggest small-vessel issues, impacting diagnosis and treatment.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Cerebrovascular Disease

Background:

  • Lacunar and cortical ischemic strokes are distinct clinical entities.
  • Transient ischemic attacks (TIAs) may also exhibit heterogeneity.

Purpose of the Study:

  • To investigate the potential heterogeneity of TIAs.
  • To differentiate between cortical and lacunar TIAs based on underlying pathology.

Main Methods:

  • Prospective study of 130 patients with TIAs.
  • Carotid angiography performed in 71 patients.
  • Correlation of TIA type with internal carotid artery stenosis.

Main Results:

  • Significant ipsilateral internal carotid artery stenosis (>50%) found in 67% of cortical TIA patients.

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  • Only 6% of lacunar TIA patients had significant stenosis (p < 0.0001).
  • Cortical TIAs associated with extracranial large-vessel disease; lacunar TIAs with intracranial small-vessel disease.

    • Conclusions:

    • Cortical TIAs are linked to extracranial carotid artery atheromatous disease.
    • Lacunar TIAs may indicate intracranial small-vessel disease.
    • Distinguishing TIA types is crucial for appropriate investigation and management.