Related Experiment Video
Updated: Jun 17, 2026

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Symptom progression or fluctuation in transient ischemic attack patients predicts subsequent stroke
Makoto Nakajima1, Teruyuki Hirano, Hiroaki Naritomi
1Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Suita, Japan. nakazima@fc.kuh.kumamoto-u.ac.jp
Background:
The aim of this study was to investigate whether progression or fluctuation of transient ischemic attack (TIA) symptoms is a predictor of subsequent stroke.
Methods:
We prospectively analyzed 113 consecutive patients admitted with a diagnosis of classical TIA with symptom duration of less than 24 h. We assessed the background characteristics, TIA symptoms, attack characteristics, results of in-hospital examinations, and prescription of antithrombotic agents on discharge for each patient. We then analyzed the factors related to progression or fluctuation of TIA symptoms.
Results:
Of the 113 patients, 35 (31.0%) exhibited symptom progression or fluctuation. Subsequent stroke occurred in 12 (10.6%) patients within 180 days. Symptom progression or fluctuation was significantly related to the TIA symptoms of speech disturbance, hemiparesis, and monoparesis, and were also related to subsequent stroke occurrence within 90 days (29 vs. 3%, p = 0.004) and 180 days (23 vs. 5%, p = 0.008). In a logistic regression model analysis, symptom progression or fluctuation was a significant predictor of subsequent stroke within 90 days (odds ratio = 7.65, 95% CI 1.27-46.06) and 180 days (odds ratio = 4.44, 95% CI 1.08-18.13), independently of other predictors demonstrated in previous studies.
Conclusions:
Progression or fluctuation of TIA symptoms may be an important predictor of subsequent stroke. A detailed interview about the characteristics of each attack is also indispensable for the provision of appropriate care to TIA patients.
Related Concept Videos
Transient Ischemic Attack l: Introduction
Ischemic Stroke ll: Pathophysiology
Ischemic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
Stroke: Introduction and Types
