SUMMARY Two hundred and three patients, 148 males and 55 females, who during the last month before admission had experienced at least one reversible cerebral ischemic attack of less than 72 hours duration, were randomly assigned to treatment with either acetylsalicylic acid (ASA) 1000 mg daily (101 patients) or placebo (102 patients). The average follow-up period was 25 months. The two treatment groups were comparable with respect to age, sex, associated diseases, risk factors, number and duration of cerebral ischemic attacks.No statistically significant differences were found between the treatment groups as to the primary end point: stroke or death (ASA group 20.8%, placebo group 16.7%). Occurrence of transient ischemic attacks during the treatment period was not reduced by ASA treatment, whereas there was a trend suggesting fewer myocardial infarctions in the ASA group (5.9%) than in the placebo group (13.7%). The difference, however, was not statistically significant (p = 0.10).We were thus unable to demonstrate any favorable influence of ASA 1000 mg daily in patients with reversible ischemic attacks. This study does not, of course, prove that ASA treatment is ineffective in stroke prevention. Stroke Vol 14, No 1, 1983PLATELET-FIBRIN EMBOLI originating from arteriosclerotic lesions in the precerebral arteries are acknowledged to be responsible for a major part of reversible ischemic cerebral attacks. 12 The recognition of the key-role played by platelets in thrombus formation in arteriosclerotic arteries has increased the interest in the use of platelet function inhibiting drugs in the prophylaxis of ischemic cerebrovascular and cardiovascular diseases. 34The results of small scale studies and two large cooperative studies suggest a beneficial effect of acetylsalicylic acid (ASA) and other platelet function inhibiting drugs in patients with transient cerebral ischemic attacks. The present study was begun in 1976, the main objective being to determine if ASA would reduce stroke frequency and mortality in patients with reversible cerebral ischemic attacks. The study was conducted as a cooperative, multicenter, double-blind, randomized clinical trial.

A significant increase in S-urate was found postictally in 17 patients with two or more grand ma1 seizures within 24 h. In six patients S-urate was above the level at which hyperuricemic renal failure may develop. Impaired renal function was observed in two patients who had extremely high S-urates. It is proposed that prophylactic procedures against hyperuricemic renal failure should be carried out in all patients with repetitive convulsions.

The therapeutic effect of lithium in Huntington's chorea was tested in six patients through a double-blind cross-over comparison of lithium and placebo, each administered for 6 weeks. Four of the patients received neuroleptic drugs at the same time. Lithium and placebo periods did not differ as regards motor skills, hyperkinesias, or total ward situation, all rated quantitatively with the use of scales. Lithium does not seem to be of therapeutic value in Huntington's chorea.

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