Transient Ischemic Attacks

Duca, Andrea; Jagoda, Andy

doi:10.1016/j.emc.2016.06.007

“…Stroke is associated with high fatality rates and major disability in survivors [2]. Transient Ischemic Attack [1] and minor ischemic stroke (IS) share similar pathophysiology to stroke [3]. Although, the ABCD2 score has been used to prognosticate the risk of subsequent stroke [4], a meta-analysis showed that it does not reliably discriminate patients at low or high risk of recurrent stroke [5].…”

Section: Introductionmentioning

confidence: 99%

Corneal nerve and endothelial cell damage in patients with transient ischemic attack and minor ischemic stroke

Gad

¹

,

Khan

²

,

Akhtar

³

et al. 2019

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ObjectiveTo determine if corneal confocal microscopy can identify corneal nerve and endothelial cell abnormalities and may be useful in the prognostication of patients with transient ischemic attack [1] or minor ischemic stroke (IS).MethodsThirty-six patients admitted with TIA (n = 14) or minor IS (n = 22) underwent transcranial Doppler evaluation and corneal confocal microscopy and were compared with 18 healthy controls.ResultsCorneal nerve fiber density (P = 0.002), branch density (P = 0.004) and fiber length (P = 0.004) were significantly lower in patients with TIA or minor IS compared to controls, with no difference between patients with TIA and minor IS. Endothelial cell density (P = 0.003) was lower and endothelial cell area (P = 0.003) and perimeter (P = 0.006) were significantly higher in patients with TIA or minor IS compared to controls, with no difference between patients with TIA and minor IS. There were no differences in corneal nerve or endothelial cell morphology between patients with and without abnormal cerebrovascular reactivity. HbA1c was independently associated with CNFL, and endothelial cell polymegathism and pleomorphism were associated with both HbA1c and total cholesterol.ConclusionCorneal confocal microscopy identifies corneal nerve fiber loss and endothelial cell abnormalities in patients with TIA and minor IS and independent associations with HbA1c and cholesterol.

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“…As the diet structure of people changes and the aging of the population accelerates, the prevalence of ICVD, most of which occurs on the basis of hemodynamic disturbance or cerebrovascular diseases, has increased rapidly, posing a serious threat to patients' life safety and quality [ 5 , 6 ]. ICVD includes transient ischemic attacks (TIA) [ 7 ] and acute cerebral infarction (ACI) [ 8 ]. Regardless of the type, artery stenosis or occlusion caused by atherosclerosis is a very important reason [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Effect of Digital Subtraction Angiography Combined with Neurointerventional Thrombolysis for Acute Ischemic Cerebrovascular Disease and Its Influence on Vascular Endothelial Function and Oxidative Stress

Wang

¹

,

Guan

²

,

Wang

³

2022

Oxidative Medicine and Cellular Longevity

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Objective. Ischemic cerebrovascular disease is a commonly seen vascular disorder in clinical practice. Given the difficulty of drug therapy to achieve ideal curative effects, interventional therapy has gradually become the preferred treatment for the disease. This research primarily discusses the short-term efficacy of digital subtraction angiography- (DSA-) guided neurointerventional thrombolysis for acute ischemic cerebrovascular disease (AICVD) and its influence on vascular endothelial function (VEF) and oxidative stress (OS). Methods. All the clinical data of 162 patients diagnosed with AICVD and treated between June 2019 and December 2021 were collected and analyzed retrospectively. They were assigned to two cohorts according to the difference in interventional methods: a conventional group (CG) given recombinant tissue plasminogen activator (rt-PA) therapy and an observation group (OG) intervened by DSA-guided neurointerventional thrombolysis. The two groups were compared with respect to short-term treatment efficacy, the National Institutes of Health Stroke Scale (NIHSS) score, cerebral hemodynamics, and VEF and OS indexes. Results. The short-term efficacy was better in OG (93.98%) than in CG (82.28%). After treatment, the NIHSS score decreased in both cohorts with obvious differences within the group at different time points, and the posttreatment NIHSS score was lower in OG as compared to CG. OG had higher Q m and V m while lower W v , Z cv , and R v than CG. Higher endothelial-dependent flow-mediated dilatation (FMD) was observed in OG, as well as lower ankle-brachial index (ABI) and pulse wave velocity (PWV). And the posttreatment MDA was lower while SOD, GSH-Px, and TAC were higher in OG compared with those on CG. All the above differences were of statistical significance ( P < 0.05 ). Conclusions. DSA-guided neurointerventional thrombolysis is highly effective in the treatment of AICVD, which can not only effectively improve patients’ neurological function and cerebral hemodynamics but also mitigate VEF injury and help to alleviate patients’ OS.

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“…Ввиду того, что подавляющее большинство ТИА имеют продолжительность менее 1 ч, а общепринятая тактика предполагает неотложную терапию острого цереброваскулярного события в период до 24 ч -временного критерия ТИА, было предложено новое определение этого состояния [6,7]. Согласно современному «тканьориентированному» определению, ТИА обозначается как преходящий неврологический дефицит, обусловленный фокальной ишемией центральной нервной системы (головного мозга, спинного мозга или сетчатки) без визуализационных признаков острого инфаркта [5,8]. Последняя дефиниция исключает из разряда ТИА непродолжительные транзиторные неврологические нарушения в случаях, когда на магнитно-резонансной томографии (МРТ) DWI выявляются очаги, указывающие на развитие острой ишемии [9][10][11].…”

unclassified

“…Заболеваемость ТИА колеблется от 0,7 до 1,08 на 1 тыс. населения [8,13]. В Российской Федерации ТИА диагностируется примерно у 40 тыс.…”

unclassified

“…пациентов ежегодно [1]. Можно допустить, что распространенность ТИА выше имеющихся данных ввиду недостаточной обращаемости за медицинской помощью, связанной с недооценкой пациентами коротких эпизодов негрубых неврологических сосудистых нарушений, особенно в случаях их нефокального характера [1,3,8].…”

unclassified

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Significance of focal and nonfocal symptoms in the diagnostics of transient vertebrobasilar ischemic syndromes

Khasanov¹,

Богданов²

2019

Z. nevrol. psikhiatr. im. S.S. Korsakova

0

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РезюмеЦель исследования. Выявление клинических и параклинических признаков, учет которых у пациентов с преходящим неврологическим дефицитом в виде симптомов поражения затылочной доли, ствола или мозжечка повышает возможность диагностики транзиторной ишемии в вертебрально-базилярной системе. Материал и методы. Получены и проанализированы клинико-анамнестические и инструментальные данные 126 пациентов, госпитализированных в первичный сосудистый центр с диагнозом острого нарушения мозгового кровообращения в вертебрально-базилярной системе, в том числе те, у кого этот диагноз предполагался при поступлении и в дальнейшем был снят. Результаты и заключение. Выявлены клинические и параклинические признаки, значимые для дифференциальной диагностики транзиторных ишемических синдромов в вертебрально-базилярной системе, и синдромов, имитирующих острую ишемию в этой системе.Ключевые слова: транзиторная ишемическая атака, вертебрально-базилярная система, острое нарушение мозгового кровообращения, транзиторная ишемическая атака. Сведения об авторах:Хасанов Ильдар Акрамович -

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Transient Ischemic Attacks

Cited by 18 publications

References 98 publications

Corneal nerve and endothelial cell damage in patients with transient ischemic attack and minor ischemic stroke

Corneal nerve and endothelial cell damage in patients with transient ischemic attack and minor ischemic stroke

Clinical Effect of Digital Subtraction Angiography Combined with Neurointerventional Thrombolysis for Acute Ischemic Cerebrovascular Disease and Its Influence on Vascular Endothelial Function and Oxidative Stress

Significance of focal and nonfocal symptoms in the diagnostics of transient vertebrobasilar ischemic syndromes

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