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Transient ischemic attacks and normal cerebral angiograms: a follow-up study
A Shuaib1, V C Hachinski, W J Oczkowski
1Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada.
Stroke
|October 1, 1988
Summary
Extensive cardiac investigations may predict outcomes for patients experiencing transient ischemic attacks (TIAs) with normal cerebral angiograms. Abnormal cardiac findings at admission correlated with a higher risk of recurrent TIAs or stroke.
Area of Science:
- Neurology
- Cardiology
- Diagnostic Imaging
Background:
- Patients with transient ischemic attacks (TIAs) and normal cerebral angiograms present a diagnostic challenge.
- Predicting the long-term outcome for this patient group is crucial for appropriate management.
Purpose of the Study:
- To determine the outcome of patients with TIAs and normal cerebral angiograms.
- To assess the role of cardiac investigations in predicting neurological and cardiac events.
Main Methods:
- A cohort of 68 patients with TIAs and normal cerebral angiograms were followed for 2-6 years.
- Patients underwent cranial computed tomography, two-dimensional echocardiography, Holter monitoring, and electrocardiography at admission.
- Outcomes assessed included recurrent TIAs, strokes, and development of cardiac disease.
Main Results:
- Among 64 patients, 9 experienced recurrent TIAs and 3 developed strokes.
- 11 patients developed cardiac disease (angina or myocardial infarction).
- Patients with abnormal cardiac findings on admission had a significantly higher rate of further neurologic or cardiac events (55.5%) compared to those with normal findings (26%).
Conclusions:
- Extensive cardiac investigations may aid in predicting the outcome for patients with TIAs and normal cerebral angiograms.
- Abnormal cardiac findings are associated with an increased risk of adverse events in this population.