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Related Experiment Video

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Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability

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Transient ischemic attack before nonlacunar ischemic stroke in the elderly.

David Della Morte¹, Pasquale Abete, Ferdinando Gallucci

¹Department of Internal Medicine, Cardiovascular Sciences, and Immunology, University Federico II, Naples, Italy. DMorte@med.miami.edu

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|August 30, 2008

Summary

Transient ischemic attacks (TIAs) did not show a protective effect against ischemic stroke in patients over 65. This suggests the neuroprotective benefits of cerebral ischemic preconditioning may be absent in the elderly.

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Area of Science:

Neurology
Geriatrics
Cardiovascular Research

Background:

Transient ischemic attacks (TIAs) are theorized to offer neuroprotection against ischemic stroke, similar to preinfarction angina's effect on myocardial infarction.
This potential protective effect, known as ischemic preconditioning, may be diminished or absent in older populations.

Purpose of the Study:

To investigate the neuroprotective effect of TIAs (cerebral ischemic preconditioning) on neurologic damage following cerebral ischemic injury in patients aged 65 and older.

Main Methods:

Retrospective review of medical charts for patients diagnosed with acute ischemic stroke.
Identification of TIAs occurring within 72 hours prior to stroke onset.
Assessment of stroke severity using the National Institutes of Health Stroke Scale (NIHSS) and disability via the modified Rankin Scale (mRS).

Main Results:

203 patients (age >= 65) with ischemic stroke were analyzed; 42 (21%) had preceding TIAs, while 161 (79%) did not.
No significant differences in NIHSS or mRS scores were found at admission or discharge between patients with and without preceding TIAs.
Hospital length of stay was comparable between the two groups (14.5 +/- 4.8 days).

Conclusions:

The findings indicate that the neuroprotective mechanism associated with cerebral ischemic preconditioning may not be functional in elderly individuals.
This suggests a potential age-related decline in the body's ability to utilize preconditioning for stroke protection.