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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Transient ischaemic attacks and small-vessel disease. Dutch TIA Study Group
L J Kappelle1, J C van Latum, P J Koudstaal
1University Department of Neurology, Utrecht, Netherlands.
Lancet (London, England)
|February 9, 1991
Summary
Transient cerebral ischemia (TCI) patients with lacunar infarcts often present with specific unilateral symptoms. This suggests lacunar TIAs may precede cortical infarcts or have a better prognosis.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- Transient cerebral ischemia (TCI) is a critical neurological event.
- Distinguishing between lacunar and cortical infarcts is essential for prognosis.
- Computed tomography (CT) plays a key role in diagnosing cerebral infarcts.
Purpose of the Study:
- To investigate the relationship between patient history and infarct type in TCI.
- To determine if specific symptoms predict lacunar infarcts.
- To compare the frequency of lacunar symptoms in patients with and without visible infarcts on CT.
Main Methods:
- Retrospective analysis of clinical histories and CT scans from 606 TCI patients.
- Exclusion of posterior fossa ischemia episodes.
- Comparison of histories for patients with and without relevant infarcts on CT.
Main Results:
- 79 relevant infarcts were identified: 46 lacunar (58%) and 33 cortical.
- Lacunar symptoms had a positive predictive value of 0.74 for lacunar infarcts.
- 64% of TCI patients without infarcts on CT reported lacunar symptoms, higher than in other studies.
Conclusions:
- Lacunar symptoms are strongly associated with lacunar infarcts.
- Lacunar TIAs might have a better prognosis or precede cortical infarcts.
- Cortical infarcts may sometimes occur without preceding warning symptoms.
