Prognosis of Patients With Transient Ischemic Attacks and Normal Angiograms

Mendelowitz, David S.; Kimmins, Sarah; Evans, William E.

doi:10.1001/archsurg.1981.01380240067010

Cited by 21 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with known cardiac diseases of potential embolic etiology were excluded from the study. 13 Finally, in the review of Poole et al, 23 of 16 patients with amaurosis fugax under the age of 40 years, carotid angiograms were normal in the 10 patients in whom it was performed; all patients were free of cardiac or cerebral disease on follow-up.…”

Section: Discussionmentioning

confidence: 96%

“…Cardiac investigation included 2-DE and HM when indicated, and workup for collagen diseases produced negative results. Mendelowitz et al 13 reported 32 patients with normal angiograms among 358 patients with TIAs over 10 years. No patient suffered cerebral infarction during followup.…”

Section: Discussionmentioning

confidence: 99%

“…12 The etiology, natural history, and prognosis in these patients is not well defined. Some articles suggest an excellent prognosis 13 while others report an outcome similar to that of patients in whom angiography shows atherosclerotic narrowing." 14 However, few patients were studied, 11 angiography was incomplete, 1415 and follow-up was limited 13 ; there-fore, no definite conclusions can be drawn from these studies.…”

mentioning

confidence: 99%

“…Some articles suggest an excellent prognosis 13 while others report an outcome similar to that of patients in whom angiography shows atherosclerotic narrowing." 14 However, few patients were studied, 11 angiography was incomplete, 1415 and follow-up was limited 13 ; there-fore, no definite conclusions can be drawn from these studies. Our study was undertaken to evaluate the outcome of patients admitted over a 4-year period to University Hospital, London, Ontario, Canada, with TIAs and normal angiograms in whom cardiac investigations were extensive.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Transient ischemic attacks and normal cerebral angiograms: a follow-up study.

Shuaib

Hachinski

Oczkowski

1988

Stroke

View full text Add to dashboard Cite

To determine the outcome of patients with carotid transient ischemic attacks (TIAs) and normal cerebral angiograms, we assessed 68 patients (40 men, 28 women) aged 24-72 (mean 53.5) years for recurrent TIAs and strokes and for the development of cardiac disease over 2-6 (mean 4.4) years. All but one patient had a follow-up interview in early 1987; that patient had died of an unrelated cause (lung cancer) 18 months after the presenting TIA. The diagnosis was changed at the follow-up interview in three patients (multiple sclerosis, meningioma, migraine). Among the 64 remaining patients, at admission cranial computed tomography had shown cerebral infarction in 11 of 64, two-dimensional echocardiography had been abnormal in nine of 61, Holter monitoring had been abnormal in eight of 45, and twelve-lead electrocardiography had been abnormal in three of 64. Two patients had abnormalities on both echocardiography and Holter monitoring. At the follow-up interview of the 64 remaining patients, TIAs had recurred in nine and three had developed a completed stroke; cardiac disease (angina in seven, myocardial infarction in four) was noted in 11 patients. Findings from cardiac investigations on admission in the nine patients with recurrent TIAs had been abnormal in six and normal in three; all three patients who developed a stroke had had abnormal cardiac findings. Overall, further neurologic or cardiac events occurred in 12 of 46 patients (26%) with normal and in 10 of 18 patients (55.5%) with abnormal findings on admission (/?<0.01). In the presence of normal angiograms, extensive cardiac investigations may help predict the outcome of patients with TIAs. (Stroke 1988;19:1223-1228) C erebral angiography shows atherosclerosis in the majority of patients who have transient ischemic attacks (TIAs) in the carotid artery territory,'-3 with the subsequent risk of stroke over 5 years ranging from 10% to 43%. 4 -9 Angiograms may, however, be normal in approximately 25% of these patients. 10 The reported frequency of normal angiograms in patients with TIAs has varied from as low as 7%" to as high as 40%. 12 The etiology, natural history, and prognosis in these patients is not well defined. Some articles suggest an excellent prognosis 13 while others report an outcome similar to that of patients in whom angiography shows atherosclerotic narrowing."14 However, few patients were studied, 11 angiography was incomplete, 1415 and follow-up was limited 13; there- Received April 4, 1988; accepted May 24, 1988. fore, no definite conclusions can be drawn from these studies. Our study was undertaken to evaluate the outcome of patients admitted over a 4-year period to University Hospital, London, Ontario, Canada, with TIAs and normal angiograms in whom cardiac investigations were extensive. Our results suggest that patients with cardiac disease (previously known or newly diagnosed during evaluation) have a higher incidence of subsequent cardiac and noncardiac complications. Cardiac investigations separate patients with TIAs and normal angiog...

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Transient ischemic attacks and normal cerebral angiograms: a follow-up study.

Shuaib

Hachinski

Oczkowski

1988

Stroke

View full text Add to dashboard Cite

show abstract

“…It would be of practical and theoretical value to know whether patients with a normal angiogram have a better prognosis than those with a known source of embolism [2,[4][5][6][7][8][9][10]. Pre vious investigations have comprised only a few patients [5], or the follow-up period has been short [8,9]. We, therefore, followed up 61 patients with a TIA or minor stroke and a normal angiogram.…”

Section: Introductionmentioning

confidence: 99%

Prognosis in Patients with Transient Ischaemic Attacks and Minor Stroke Associated with a Normal Angiogram

Vrethem¹,

Johansson²

1990

Eur Neurol

View full text Add to dashboard Cite

61 patients with a transient ischaemic attack (TIA) or minor stroke and a normal angiogram and with no other explanation for the ischaemic event were followed up for a mean period of 6.3 years. Of 19 patients with a TIA 5 suffered further TIAs, and 1 of the 5 also an ischaemic stroke. 3 of 42 patients with a minor stroke had a new ischaemic stroke, in 1 case preceded by a TIA. In 2 stroke patients the lesion affected a new arterial region. 3 patients died of cerebral haematoma, in 1 preceded by an ischaemic stroke. 4 patients suffered myocardial infarction, and 1 of these died. The overall incidence of recurrent cerebral and cardiovascular symptoms was 23% (14 of 61 patients). The mean age was significantly higher (p < 0.01) in patients with recurrent cerebral and cardiovascular lesions. No correlation emerged between risk factors. Patients with a TIA or minor stroke and a normal angiogram and with no other known source of embolism have a better prognosis than patients with a known source of embolism. However, elderly patients in particular run an increased risk of cardiac and cerebral vascular incidents.

show abstract