Related Experiment Video
Updated: May 16, 2026
05:32
Transient Middle Cerebral Artery Occlusion Model of Stroke
Published on: August 11, 2023
Transient neurological attack before vertebrobasilar stroke.
Takao Hoshino1, Takehiko Nagao, Satoko Mizuno
1Department of Neurology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. thoshino@nij.twmu.ac.jp
Journal of the Neurological Sciences
|December 14, 2012
Summary
Transient ischemic attacks (TIAs) in vertebrobasilar circulation may be missed if symptoms like vertigo occur alone. Many TIAs are misdiagnosed as nonspecific transient neurological attacks (TNAs).
Area of Science:
- Neurology
- Vascular Neurology
- Cerebrovascular Diseases
Background:
- Vertebrobasilar (VB) circulation ischemia presents with nonspecific symptoms, complicating TIA diagnosis.
- Current classifications exclude isolated VB symptoms like vertigo from typical TIA definitions, lacking strong evidence.
- Distinguishing TIA from other disorders in VB circulation ischemia is challenging due to overlapping, nonspecific symptoms.
Purpose of the Study:
- To investigate the incidence and clinical characteristics of transient neurological attacks (TNAs) preceding acute ischemic VB stroke.
- To compare patients with and without prior TNA history regarding their background and stroke profiles.
- To determine if clinically nonfocal TNAs are overlooked causes of TIA in VB circulation ischemia.
Main Methods:
- A hospital-based study of 214 consecutive patients with acute ischemic VB stroke.
- TNAs were defined as temporary episodes (<24h) with neurological symptoms, categorized into TIA, nonspecific TNA, or other specific disorders.
- Incidence and symptoms of TNAs within 3 months prior to stroke were analyzed, with comparisons between TNA history groups.
Main Results:
- 26.2% of VB stroke patients (56/214) had prior TNAs; 33 were diagnosed as TIA and 17 as nonspecific TNA.
- 42% of these TNAs (21/50) presented with isolated nonfocal symptoms, with 4 confirmed as acute infarction.
- Vertigo was the most common nonspecific TNA symptom; prior TNA patients had a higher rate of atherothrombotic stroke (40.0% vs. 21.5%).
Conclusions:
- A significant proportion of TIAs in VB circulation ischemia may be unrecognized, often presenting as clinically nonfocal TNAs.
- Nonspecific symptoms like isolated vertigo can be indicators of underlying TIA in VB circulation.
- Rethinking TIA diagnostic criteria for VB circulation ischemia is warranted to include nonspecific presentations.
Related Concept Videos
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
01:29Stroke: Introduction and Types
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:28Traumatic Brain Injury l: Introduction
DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...