Transient cerebral ischemic attacks in the young and middle aged. A population study

During an investigation of coronary risk factors, a population 20 to 54 years old in Tromsø, Northern Norway was screened for transient ischemic cerebral attacks. Three simple screening questions were used. Sixteen thousand six hundred and twenty-one subjects participated in the study. Among the responders, a sample of 501 were evaluated neurologically and 10 men and 16 women identified as TIA cases. Mean age for men was 41.3 years, for women 33 years. Five women (mean age 24.4) had the events during pregnancy, pointing to pregnancy as a period of risk. Five-year incidence was found to be 2.5. per 1000. Clinical expressions and ratio carotid to vertebral-basilar TIA hardly differed from that found in materials of older patients. All 26 remained stroke-free during a mean observation period of 55 months. Known risk factors like hypertension, carotid stenosis and cardiac disease were found in only a few. Five women had low blood pressure. It is suggested that TIA in younger age groups may constitute a separate entity where, among other, haemodynamic factors and pregnancy play a role.