Factors Associated with Cognitive Decline in Transient Ischemic Attack Patients

Abstract

Stroke is the leading cause of prolonged disability in the elderly and the second most common cause of death. 1,2 prior to stroke individuals often experience minor cerebrovascular events such as transient ischemic attacks (tias). according to the World health organization criteria, a tia is defined as a focal neurological deficit lasting for less than 24 hours and presumed to be of vascular origin. 3 these events have been considered crucial "warning signs" for increased risk of an upcoming stroke. Stroke has been shown to follow a tia in 12 to 30% of patients, and the highest risk of recurrent cerebral ischemia is within the first 24 hours of the initial event. 4 Without early detection and proper treatment, tias can be followed by more severe ischemic stroke.Cerebrovascular disease is associated with cognitive impairment that significantly impacts patients in the long term. up to 25% of stroke survivors meet the criteria for dementia within 12 months of an ischemic event. 5,6 . Chronic cerebrovascular changes, without overt clinical evidence of an ischemic stroke, can lead to cognitive decline, ultimately resulting in vascular dementia. in tia patients, symptoms and tissue deficits are by definition considered temporary, but cognitive impairments have been identified in some studies after initial focal symptoms have resolved.7-9 imaging studies in tia/minor stroke patients have identified correlates of cognitive deficits, but a profile describing how cognitive changes evolve over time has not been established. it is unknown whether cognitive impairments remain stable, worsen, or resolve in time ABSTRACT: Chronic cerebrovascular disease and large ischemic stroke are both associated with cognitive impairment. Much less is known about the acute cognitive sequelae of transient ischemic attack (tia). although often overlooked, there is increasing evidence that cognitive impairment does occur following tia. in some patients, cognitive changes persist after resolution of focal neurological deficits, but the temporal profile of these symptoms is unknown. in addition, clinical and imaging correlates of cognitive impairment after tia have not been systematically studied. this under-studied and recognized problem has significant implications for tia patient management. in this review, we summarize the evidence currently available and identify future research priorities.RÉSUMÉ: Facteurs associés au déclin cognitif chez les patients présentant un accident ischémique transitoire. la maladie vasculaire cérébrale chronique et l'accident vasculaire cérébral extensif sont tous deux associés à un déficit cognitif. on connaît moins bien les séquelles cognitives aiguës d'un accident ischémique transitoire (ait). bien que ce soit rarement pris en compte, il y a de plus en plus de données en faveur de la présence d'un déficit cognitif suite à un ait. Chez certains patients, les changements cognitifs persistent après la résolution des déficits neurologiques focaux, mais le profil temporel de ces symptômes demeure inconnu. de plus, l...

Daily life consequences, cognitive impairment, and fatigue after transient ischemic attack

“…Mild cognitive impairment was present in a significant portion of this sample with TIA. Cognitive decline can occur due to different causes, such as vascular risk factors and biological aging, and these characteristics are common among patients with TIA diagnosis . Cognitive decline is a strong predictor for TIA/stroke , and cognitive impairment may have occurred before the TIA event for some of the participants in this study.…”

Molecular magnetic resonance imaging discloses endothelial activation after transient ischaemic attack

“…Large cohort studies have demonstrated that TIA confers substantial short-and long-term risks of stroke, vascular events, myocardial infarction, cognitive impairment, and even death (Touzé et al, 2005;Giles and Rothwell, 2007;Sivakumar et al, 2014). Thus, TIA is a 'warning' event that provides an opportunity for prevention, and new guidelines highlight the need for urgent assessment of those patients.…”

Dl-3-N-Butylphthalide Promotes Angiogenesis in an Optimized Model of Transient Ischemic Attack in C57BL/6 Mice

“…Moreover, the risk of stroke within 90 days after TIA is 10–20%, of which 50% occur within the first 2 days ( Hill et al, 2004 ; Johnston et al, 2007 ). In addition, patients with TIA may experience brain atrophy and cognitive decline, which is a key risk factor for dementia ( Sivakumar et al, 2014 ; van Rooij et al, 2014 ; Bivard et al, 2018 ). However, the pathogenesis and pathophysiological changes associated with TIA have not been fully clarified.…”