Comparison of Risk Factors in Patients With Transient and Prolonged Eye and Brain Ischemic Syndromes

Stroke - Tập 33 Số 10 - Trang 2383-2390 - 2002
Gillian Mead1, Steff Lewis1, Joanna M. Wardlaw1, Martin Dennis1
1From the Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, Scotland.

Tóm tắt

Background and Purpose— Patients with ischemic stroke, cerebral transient ischemic attacks (TIAs), retinal artery occlusion (RAO), and amaurosis fugax are thought to have similar risk factors and underlying vascular disease. However, if risk factors are different in patients with eye compared with brain symptoms and in those whose symptoms last <24 hours (transient) compared with those lasting >24 hours (prolonged), more focused prevention strategies are possible in the future. Methods— All patients with ischemic stroke, cerebral TIA, RAO, and amaurosis fugax presenting to our hospital from 1994 to 1999 were examined by a stroke physician. Risk factors were documented, and patients underwent carotid Doppler ultrasound. Results— We registered 1491 patients with ischemic stroke, 580 with cerebral TIA, 79 with RAO, and 138 with amaurosis fugax. Atrial fibrillation was more common in brain than eye events, whether prolonged [ischemic stroke versus RAO: odds ratio (OR), 3.6; 95% confidence interval (CI), 1.1 to 12] or transient (cerebral TIA versus amaurosis fugax: OR, 2.9; 95% CI, 0.7 to 13), and more common in prolonged than transient events, whether brain (stroke versus cerebral TIA: OR, 3.3; 95% CI, 2.1 to 5.1) or eye (RAO versus amaurosis fugax: OR, 2.7; 95% CI, 0.4 to 16). Severe ipsilateral carotid disease was less common in brain than eye events, whether prolonged (ischemic stroke versus RAO: OR, 0.6; 95% CI, 0.3 to 1.0) or transient (cerebral TIA versus amaurosis fugax: OR, 0.4; 95% CI, 0.2 to 0.6). Conclusions— These data suggest that there are pathogenetic differences between transient and permanent eye and brain ischemic syndromes. Improved understanding of these mechanisms could lead to more effective stroke prevention.

Từ khóa


Tài liệu tham khảo

Warlow CP Dennis MS van Gijn J Hankey GJ Sandercock PAG Bamford M Wardlaw JM. In: Stroke: A Practical Guide to Management. Oxford UK: Blackwell Scientific Press; 2000: 191–193.

10.1136/bmj.1.6003.205

10.1161/str.12.6.7303066

10.1007/BF02043217

10.1016/S0950-821X(87)80077-4

10.1161/str.20.11.2815184

Errando AD, Puiggros AC. Risk factors and prognostic variables in transient ischemic attacks and infarcts with minimal sequelae: a comparative multivariate study. Med Clin (Barc). 1991; 96: 441–444.

Falke P, Lindgarde F, Stavenow L. Prognostic indicators for mortality in transient ischemic attack and minor stroke. Acta Neurol Scand. 1994; 90: 78–82.

10.1161/str.26.4.614

10.1161/str.29.1.40

10.1212/WNL.30.10.1041

10.1002/ana.410180612

Stavenow L, Bjerre P, Lindgarde F. Patients with reversible ischemic neurological deficit (RIND) have less severe carotid artery lesions than those with transient ischemic attack (TIA) evaluated by duplex ultrasound. Int Angiol. 1988; 7: 32–36.

10.1001/archneur.1995.00540270034016

Nguyen TN, Gans MS, Cote R. The prognosis of amaurosis fugax and hemispheric transient ischemic attacks. Can J Ophthalmol. 1999; 34: 210–216.

10.1136/jnnp.48.9.902

10.1136/jnnp.55.8.640

10.1016/S0140-6736(97)09292-1

Zwiebel WJ. Analysis of carotid Doppler signals.In: Introduction to Vascular Ultrasonography. Philadelphia Pa: WB Saunders Co; 1986; 171–216.

Hugh AE. The carotid siphon: a natural arterial filter? Lancet. 1987; 2: 886–887.

10.1016/0026-2862(88)90036-2

Thông tin
Thông tin xuất bản

Stroke

Tập 33 Số 10

2383-2390

Thông tin tác giả