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[Transitory carotid ischemic attacks: clinical and pathogenic aspects].

E Fiorini1, F Regli, J Bogousslavsky

  • 1Service de neurologie, Centre hospitalier universitaire vaudois, Lausanne.

Schweizer Archiv Fur Neurologie Und Psychiatrie (Zurich, Switzerland : 1985)
|January 1, 1991
PubMed
Summary

This study on carotid transient ischemic attacks (TIA) found common risk factors like hypertension and smoking. Atherosclerosis is a frequent cause, and some TIAs were linked to cerebral infarction.

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Cardiology

Background:

  • Transient ischemic attacks (TIAs) are critical indicators of cerebrovascular disease.
  • Understanding the clinical profile and underlying mechanisms of carotid TIAs is essential for effective prevention and treatment.

Purpose of the Study:

  • To elucidate the clinical characteristics of carotid transient ischemic attacks (TIAs).
  • To investigate the pathological mechanisms contributing to TIAs in a hospitalized patient cohort.
  • To identify prevalent risk factors and etiological pathways associated with TIAs.

Main Methods:

  • Retrospective analysis of 117 patients hospitalized for TIAs.
  • Clinical data collection including demographics, cardiovascular risk factors, and neurological symptoms.

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  • Cerebral infarction confirmation using CT-Scan and assessment of lesion characteristics.
  • Categorization of TIAs based on affected brain hemisphere and presence of retinal symptoms.

    • Main Results:

    • Male predominance observed in most age groups, with exceptions in the youngest and oldest cohorts.
    • Key risk factors identified: arterial hypertension, smoking, hyperlipidemia, intermittent claudication, and elevated hematocrit (>46%).
    • Cerebral infarction was confirmed in 17% of patients with hemispheric and mixed TIAs.
    • Atherosclerotic causes were more prevalent in mixed and retinal TIAs compared to hemispheric TIAs.
    • Cardiac embolism accounted for 11% of TIAs as an individual cause and 5% when associated with carotid atherosclerosis.

    Conclusions:

    • Carotid TIAs present with distinct clinical features and are associated with significant cardiovascular risk factors.
    • Atherosclerosis is a major contributor, particularly in mixed and retinal TIAs, potentially due to more severe stenosis.
    • Cerebral infarction is a common complication, underscoring the severity of these events.
    • Cardiac embolism represents a notable, albeit less frequent, pathogenic mechanism.