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Transient Ischemic Attacks Preceding Acute Lacunar Infarction.

Jae Guk Kim1, Hanna Choi, Sung-Yeon Sohn

  • 1Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejon, Republic of Korea.

European Neurology
|October 31, 2016
PubMed
Summary

Patients experiencing transient ischemic attacks (TIAs) before acute lacunar stroke, particularly those with diabetes, showed better recovery outcomes. This suggests a potential role for ischemic tolerance in lacunar infarction prognosis.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Stroke Research

Background:

  • Transient ischemic attacks (TIAs) can precede acute lacunar stroke in some patients.
  • Understanding the factors and prognostic implications of pre-stroke TIAs is crucial for managing lacunar infarction.

Purpose of the Study:

  • To evaluate the factors associated with transient ischemic attacks (TIAs) preceding acute lacunar stroke.
  • To determine the prognostic value of TIAs in patients with acute lacunar infarction.

Main Methods:

  • A cohort of 314 patients with first-ever acute lacunar infarction was analyzed.
  • Patients were categorized into two groups: those with and without a history of preceding TIAs.

Main Results:

  • 18.5% of patients reported preceding TIAs, with 87.9% occurring less than 24 hours before stroke.
  • Diabetes mellitus was significantly more prevalent in the TIA group (48.3% vs. 28.9%).
  • Patients with preceding TIAs demonstrated a more favorable outcome at 3 months (modified Rankin Scale 0-1: 79.6% vs. 63.2%).

Conclusions:

  • Preceding TIAs in acute lacunar stroke may be linked to microatheromatous changes in small perforating arteries, potentially exacerbated by diabetes.
  • The findings suggest that ischemic tolerance might contribute to better recovery in patients experiencing TIAs before a lacunar infarct.