Etiopathogenesis of Transient Ischemic Attacks and Minor Ischemic Strokes

Autor: L. E. Clavería, Angel P. Sempere, C. Cabezas, Jacinto Duarte
Rok vydání: 1998
Předmět:
Male
Arteriosclerosis
Embolism
Myocardial Ischemia
Rural Health
Brain Ischemia
Risk Factors
Atrial Fibrillation
Epidemiology
Prevalence
Carotid Stenosis
Prospective Studies
Registries
Peripheral Vascular Diseases
medicine.diagnostic_test
Smoking
Angiography
Magnetic Resonance Imaging
Ischemic Attack
Transient
Hypertension
Cardiology
Female
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Heart Diseases
Hypercholesterolemia
Ischemia
Arterial Occlusive Diseases
Diabetes Complications
Central nervous system disease
Internal medicine
Diabetes Mellitus
medicine
Humans
Vascular Diseases
Aged
Advanced and Specialized Nursing
business.industry
Vascular disease
Ultrasonography
Doppler
medicine.disease
Surgery
Cerebrovascular Disorders
Stenosis
Spain
Etiology
Feasibility Studies
Neurology (clinical)
Tomography
X-Ray Computed
business
Magnetic Resonance Angiography
Zdroj: Stroke. 29:40-45
ISSN: 1524-4628
0039-2499
Popis: Background and Purpose —We sought to analyze the etiology and underlying vascular risk factors of transient ischemic attacks (TIAs) and minor ischemic strokes (MISs). Methods —We prospectively studied the vascular risk factors and etiologic categories in 235 patients with TIAs and MISs from a community-based register in a rural area of Spain. Five etiologic categories were considered: (1) cardioembolism, (2) large-artery atherosclerosis, (3) small-artery disease, (4) other etiologies, and (5) undetermined etiology. Systematic investigations included neuroimaging (CT/MRI) and vascular studies (duplex scan/MR angiography and angiography in selected cases). Results —The two most frequent etiologic categories were small-artery disease (31%) and cardioembolism (26%). Large-artery atherosclerosis was detected in 11% of the patients. Significant carotid stenosis (≥50%) was present in 13% of patients with carotid territory events. No cause could be found or it was uncertain in almost one third of the patients. The distribution of etiologic categories was similar in TIAs and MISs. The most prevalent vascular risk factors were as follows: arterial hypertension (50%), smoking (26%), atrial fibrillation (20%), hypercholesterolemia (17%), diabetes (15%), ischemic heart disease (12%), and peripheral vascular disease (3%). Carotid bruits were detected in 3% of the patients. Conclusions —An etiologic classification of TIAs and MISs is feasible. The two most frequent pathogenetic mechanisms in our study were small-artery disease and cardioembolism. The prevalence of large-artery atherosclerosis was low.
Databáze: OpenAIRE
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