Abstract
Transient ischemic attacks (TIA)-reversible ischemic neurological deficits (RIND) are regarded as precursors and risk factors of complete strokes. I evaluated 54 patients who had complete strokes with a history of TIA or RIND (cerebral infarction with full recovery within three days) and studied their clinical features and neuroradiological aspects.
I classified TIA and RIND according to the duration, frequency and the interval between the initial attacks and the complete strokes. A type of TIA with short duration occurred rather frequently and its interval was shorter than others. In comparison, a type with long duration and RIND usually occurred less frequently, and the time lapse before the complete strokes was longer.
As to their past histories, 74% had hypertension, 30%, cardiovascular diseases, and 21%, diabetes mellitus. The high rate of ST-T wave changes on the electrocardiogram was recognized, suggesting their possible correlation to the cardiovascular diseases.
In 69% of the 54 cases, TIA-RIND occurred within the internal carotid artery (ICA) system, inducing the infarction within the same territory. Most of the TIA-RIND occurred within the vertebral basilar artery (VB) system that led to the infarction within the ICA territory.
The CT findings revealed the infarctions in various sites, and no difference was noted in the infarction distribution depending on the types of TIA. The angiography revealed the abnormalities limited to the ex tracranial vessels in 21%, intracranial in 32%, combined type in 26%, and no vascular abnormalities in 21%. In many of the cases with short duration and intermittent attacks, the abnormalities in the extracranial vessels were recognized.
Regarding the prognoses for their functional recovery and survival, the types of attacks were distributed widely according to the ADLclassification. However, the prognoses were poor in the types with short duration, intermittent attacks and short intervals, and so were those in the cases complicated with hypertension and cardiovascular disease.
