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Predictive implications of recurrent transient ischemic attacks in large artery atherosclerosis

 Kim S.H.  ;  Han S.W.  ;  Heo J.H. 
 CEREBROVASCULAR DISEASES, Vol.22(4) : 240-244, 2006 
Journal Title
Issue Date
Angiography, Digital Subtraction ; Anterior Cerebral Artery/diagnostic imaging ; Carotid Arteries/diagnostic imaging ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging* ; Diffusion Magnetic Resonance Imaging ; Embolism/complications ; Female ; Heart Diseases/complications ; Humans ; Intracranial Arteriosclerosis/complications* ; Intracranial Arteriosclerosis/diagnostic imaging ; Ischemic Attack, Transient/diagnostic imaging ; Ischemic Attack, Transient/etiology* ; Ischemic Attack, Transient/prevention & control ; Male ; Middle Aged ; Middle Cerebral Artery/diagnostic imaging ; Recurrence ; Registries* ; Retrospective Studies ; Vertebral Artery/diagnostic imaging ; Vertebrobasilar Insufficiency/complications* ; Vertebrobasilar Insufficiency/diagnostic imaging
Transient ischemic attacks ; Recurrences ; transient ischemic attacks ; Mechanisms ; transient ischemic attacks ; Large-artery atherosclerosis
BACKGROUND: It is uncertain whether recurrent transient ischemic attacks (R-TIAs), when comparing with single TIAs (S-TIAs), have any distinct mechanisms. METHODS: All consecutive patients with TIAs, who had been admitted for a 2-year period, were divided into two groups: those who had R-TIAs and those who had S-TIAs. Registry data, medical records, and imaging findings were reviewed and compared between the two groups. RESULTS: There were 85 patients who had TIAs: 42 patients had R-TIAs, and 43 patients had S-TIAs. On univariate analysis, R-TIA patients had less cardiac embolic TIA sources, less weakness, less speech disturbances, shorter symptom duration, a longer time interval from onset to treatment, less abnormalities on diffusion-weighted magnetic resonance imaging, and more significant relevant arterial stenoses. After logistic regression analysis, independent factors associated with R-TIAs were symptom duration < 10 min (odds ratio OR 3.62; 95% confidence interval CI 1.37-9.57), > or = 50% stenosis of the clinically relevant artery (OR 7.08; 95% CI 1.29-38.71), and absence of cardiac embolic sources (OR 0.04; 95% CI 0.002-0.71). CONCLUSIONS: R-TIAs may have pathophysiological mechanisms distinct from those of S-TIAs and so may provide a clue for the etiologic diagnosis, in that patients with R-TIAs are more likely to have large-artery atherosclerosis.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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