Yıl: 2020 Cilt: 54 Sayı: 1 Sayfa Aralığı: 83 - 87 Metin Dili: İngilizce DOI: 10.14744/SEMB.2018.20438 İndeks Tarihi: 18-11-2020

The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up

Öz:
Objectives: Transient Ischemic Attack (TIA) is due to a temporary lack of adequate blood and oxygen to the brain. TIAs typicallylast less than 24 hours. 10-15% of ischemic stroke patients have a history of TIA. 18% of them experience an ischemic stroke within90 days, and the ABCD2 scoring system is used to estimate the risk. Our study aims to investigate the risk factors, the etiology, thelesion occurrence on MRI and the near-term risk of stroke of patients on whom TIA was diagnosed.Methods: In this study, 124 patients were included between January 2012 and January 2018. Sixty-eight of the 124 patients weremale. The history of patients was questioned; systemic and neurological examinations were made. The stroke risk factors and TIAduration were noted and ABCD2 scores were calculated. All the patients’ blood samples, including glucose and lipid profile, werestudied. They received CT, DWI MRI, electrocardiography, transthoracic echocardiography, ultrasound and/or MR angiography ofthe cervical arteries.Results: One hundred twenty-four patients were included in this study, and 56 patients were female. The mean age was63.04±16.77. Hypertension was the most common risk factor (50.8%). Twenty-seven patients were on antithrombotic; six patientswere on anticoagulant therapy, while 91 patients were not receiving any antiaggregan therapy. ABCD2 scores were significantlyhigher on the antithrombotic therapy group (p=0.019). In 52 patients ABCD2 score was below 4, and in 72 patients, the score wasgreater than 4. In 67.7% of patients, no etiology was found. An ischemic lesion was detected in 16.9% of the patients. 58 % of thepatients were discharged on anticoagulant therapy. Five patients developed ischemic stroke.Conclusion: The risk factors of ischemic stroke and TIAs are similar factors. The etiology of TIAs cannot be found out in most of thepatients. Thus, the patients are discharged with oral anticoagulant treatment.
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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Albers GW, Caplan LR, Easton JD, Fayad PB, Mohr JP, Saver JL, et al; TIA Working Group. Transient ischemic attack--proposal for a new definition. N Engl J Med 2002;347:1713–6.
  • 2. Hankey GJ, Warlow CP. Transient Ischaemic Attacks of the Brain and Eye: Major Problems in Neurology. London: WB Saunders; 1994. p. 27.
  • 3. Kutluk K. İnmede Etyoloji, Sınıflandırma ve Risk faktörleri. In: Balkan S, editor. Serebrovasküler Hastalıklar. Güneş Kitabevi; 2009. p. 63–70.
  • 4. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al; American Heart Association; American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Interdisciplinary Council on Peripheral Vascular Disease. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke 2009;40:2276–93.
  • 5. Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA 2000;284:2901–6.
  • 6. Whiteley W, Tseng MC, Sandercock P. Blood biomarkers in the diagnosis of ischemic stroke: a systematic review. Stroke 2008;39:2902–9.
  • 7. Fazekas F, Fazekas G, Schmidt R, Kapeller P, Offenbacher H. Magnetic resonance imaging correlates of transient cerebral ischemic attacks. Stroke 1996;27:607–11.
  • 8. Bhadelia RA, Anderson M, Polak JF, Manolio TA, Beauchamp N, Knepper L, et al. Prevalence and associations of MRI-demonstrated brain infarcts in elderly subjects with a history of transient ischemic attack. The Cardiovascular Health Study. Stroke 1999;30:383–8.
  • 9. American Heart Association. 1999 heart and stroke statistical update. Dallas, Texas.1999.
  • 10. Özdemir G, Özkan S, Uzuner N, Özdemir Ö, Gücüyener D. Türkiye’de beyin damar hastalıkları için majör risk faktörleri. Türk çok merkezli stroke çalışması. Türk Beyin Damar Hastalıkları Dergisi 2000;6:31–5.
  • 11. Rodriguez-Colon SM, Mo J, Duan Y, Liu J, Caulfield JE, Jin X, et al. Metabolic syndrome clusters and the risk of incident stroke: the atherosclerosis risk in communities (ARIC) study. Stroke 2009;40:200–5.
  • 12. Gorelick PB. Stroke prevention therapy beyond antithrombotics: unifying mechanisms in ischemic stroke pathogenesis and implications for therapy: an invited review. Stroke 2002;33:862–75.
  • 13. Amarenco P, Tonkin AM. Statins for stroke prevention: disappointment and hope. Circulation 2004;109:III44–9.
  • 14. Marma AK, Lloyd-Jones DM. Systematic examination of the updated Framingham heart study general cardiovascular risk profile. Circulation 2009;120:384–90.
  • 15. Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA 2000;284:2901–6.
  • 16. Lovett JK, Dennis MS, Sandercock PA, Bamford J, Warlow CP, Rothwell PM. Very early risk of stroke after a first transient ischemic attack. Stroke 2003;34:e138–40.
  • 17. Amarenco P, Labreuche J, Lavallée PC, Meseguer E, Cabrejo L, Slaoui T, et al. Does ABCD2 score below 4 allow more time to evaluate patients with a transient ischemic attack? Stroke 2009;40:3091–5.
  • 18. A randomized trial of anticoagulants versus aspirin after cerebral ischemia of presumed arterial origin. The Stroke Prevention in Reversible Ischemia Trial (SPIRIT) Study Group. Ann Neurol 1997;42:857–65.
  • 19. Nagura J, Suzuki K, Johnston SC, Nagata K, Kuriyama N, Ozasa K, et al. Diffusion-weighted MRI in evaluation of transient ischemic attack. J Stroke Cerebrovasc Dis 2003;12:137–42.
  • 20. Ay H, Oliveira-Filho J, Buonanno FS, Schaefer PW, Furie KL, Chang YC, et al. 'Footprints' of transient ischemic attacks: a diffusionweighted MRI study. Cerebrovasc Dis 2002;14:177–86.
  • 21. Crisostomo RA, Garcia MM, Tong DC. Detection of diffusionweighted MRI abnormalities in patients with transient ischemic attack: correlation with clinical characteristics. Stroke 2003;34:932–7.
  • 22. Coutts SB, Simon JE, Eliasziw M, Sohn CH, Hill MD, Barber PA, et al. Triaging transient ischemic attack and minor stroke patients using acute magnetic resonance imaging. Ann Neurol. 2005 Jun;57(6):848–54.
  • 23. Redgrave JN, Coutts SB, Schulz UG, Briley D, Rothwell PM. Systematic review of associations between the presence of acute ischemic lesions on diffusion-weighted imaging and clinical predictors of early stroke risk after transient ischemic attack. Stroke 2007;38:1482–8.
  • 24. Purroy F, Montaner J, Rovira A, Delgado P, Quintana M, AlvarezSabín J. Higher risk of further vascular events among transient ischemic attack patients with diffusion-weighted imaging acute ischemic lesions. Stroke 2004;35:2313–9.
APA çoban e, Senadim S, YILMAZ A, Küçükoğlu H, KÖKSAL A, Atakli H, Soysal A (2020). The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. , 83 - 87. 10.14744/SEMB.2018.20438
Chicago çoban eda,Senadim Songul,YILMAZ AYŞE,Küçükoğlu Hayriye,KÖKSAL Ayhan,Atakli Hayrunisa Dilek,Soysal Aysun The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. (2020): 83 - 87. 10.14744/SEMB.2018.20438
MLA çoban eda,Senadim Songul,YILMAZ AYŞE,Küçükoğlu Hayriye,KÖKSAL Ayhan,Atakli Hayrunisa Dilek,Soysal Aysun The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. , 2020, ss.83 - 87. 10.14744/SEMB.2018.20438
AMA çoban e,Senadim S,YILMAZ A,Küçükoğlu H,KÖKSAL A,Atakli H,Soysal A The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. . 2020; 83 - 87. 10.14744/SEMB.2018.20438
Vancouver çoban e,Senadim S,YILMAZ A,Küçükoğlu H,KÖKSAL A,Atakli H,Soysal A The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. . 2020; 83 - 87. 10.14744/SEMB.2018.20438
IEEE çoban e,Senadim S,YILMAZ A,Küçükoğlu H,KÖKSAL A,Atakli H,Soysal A "The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up." , ss.83 - 87, 2020. 10.14744/SEMB.2018.20438
ISNAD çoban, eda vd. "The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up". (2020), 83-87. https://doi.org/10.14744/SEMB.2018.20438
APA çoban e, Senadim S, YILMAZ A, Küçükoğlu H, KÖKSAL A, Atakli H, Soysal A (2020). The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. Şişli Etfal Hastanesi Tıp Bülteni, 54(1), 83 - 87. 10.14744/SEMB.2018.20438
Chicago çoban eda,Senadim Songul,YILMAZ AYŞE,Küçükoğlu Hayriye,KÖKSAL Ayhan,Atakli Hayrunisa Dilek,Soysal Aysun The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. Şişli Etfal Hastanesi Tıp Bülteni 54, no.1 (2020): 83 - 87. 10.14744/SEMB.2018.20438
MLA çoban eda,Senadim Songul,YILMAZ AYŞE,Küçükoğlu Hayriye,KÖKSAL Ayhan,Atakli Hayrunisa Dilek,Soysal Aysun The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. Şişli Etfal Hastanesi Tıp Bülteni, vol.54, no.1, 2020, ss.83 - 87. 10.14744/SEMB.2018.20438
AMA çoban e,Senadim S,YILMAZ A,Küçükoğlu H,KÖKSAL A,Atakli H,Soysal A The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. Şişli Etfal Hastanesi Tıp Bülteni. 2020; 54(1): 83 - 87. 10.14744/SEMB.2018.20438
Vancouver çoban e,Senadim S,YILMAZ A,Küçükoğlu H,KÖKSAL A,Atakli H,Soysal A The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up. Şişli Etfal Hastanesi Tıp Bülteni. 2020; 54(1): 83 - 87. 10.14744/SEMB.2018.20438
IEEE çoban e,Senadim S,YILMAZ A,Küçükoğlu H,KÖKSAL A,Atakli H,Soysal A "The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up." Şişli Etfal Hastanesi Tıp Bülteni, 54, ss.83 - 87, 2020. 10.14744/SEMB.2018.20438
ISNAD çoban, eda vd. "The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up". Şişli Etfal Hastanesi Tıp Bülteni 54/1 (2020), 83-87. https://doi.org/10.14744/SEMB.2018.20438