Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries

Background/Aims: The aims of this study were to determine the differences in clinical characteristics and the risk of ischemic stroke between patients with transient ischemic attack (TIA) attributable to extracranial carotid and intracranial artery occlusive lesions. Methods: Among 445 patients admi...

Full description

Bibliographic Details
Main Authors: Toshiyuki Uehara, Tomoyuki Ohara, Kazunori Toyoda, Kazuyuki Nagatsuka, Kazuo Minematsu
Format: Article
Language:English
Published: Karger Publishers 2015-10-01
Series:Cerebrovascular Diseases Extra
Subjects:
Online Access:http://www.karger.com/Article/FullText/440731
id doaj-b3bb03bf44b846dfa485dcd99247ecc0
record_format Article
spelling doaj-b3bb03bf44b846dfa485dcd99247ecc02020-11-25T03:43:01ZengKarger PublishersCerebrovascular Diseases Extra1664-54562015-10-015311512310.1159/000440731440731Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial ArteriesToshiyuki UeharaTomoyuki OharaKazunori ToyodaKazuyuki NagatsukaKazuo MinematsuBackground/Aims: The aims of this study were to determine the differences in clinical characteristics and the risk of ischemic stroke between patients with transient ischemic attack (TIA) attributable to extracranial carotid and intracranial artery occlusive lesions. Methods: Among 445 patients admitted to our stroke care unit within 48 h of TIA onset between April 2008 and December 2013, 85 patients (63 men, mean age 69.4 years) with large artery occlusive lesions relevant to symptoms were included in this study. The primary endpoints were ischemic stroke at 2 and 90 days after TIA onset. Results: Twenty-eight patients had carotid artery occlusive lesions (extracranial group), and 57 patients had intracranial artery occlusive lesions (intracranial group). Patients in the intracranial group were significantly younger, had lower levels of fibrinogen, and were less likely to have occlusion when compared with those in the extracranial group. Eleven patients in the extracranial group and none in the intracranial group underwent revascularization procedures within 90 days of TIA onset. The 2-day risk (14.2 vs. 0%, p = 0.044) and the 90-day risk (17.1 vs. 0%, p = 0.020) of ischemic stroke after TIA onset were significantly higher in the intracranial group than in the extracranial group. Conclusions: Among our patients with TIA caused by large artery disease, patients with intracranial artery occlusive lesions were more frequent and were at higher risk of early ischemic stroke than those with extracranial carotid artery occlusive lesions. These data highlight the importance of prompt assessment of intracranial artery lesions in patients with TIA.http://www.karger.com/Article/FullText/440731Acute ischemic lesionsCarotid arteryIntracranial arteryIschemic strokeStenosisTransient ischemic attack
collection DOAJ
language English
format Article
sources DOAJ
author Toshiyuki Uehara
Tomoyuki Ohara
Kazunori Toyoda
Kazuyuki Nagatsuka
Kazuo Minematsu
spellingShingle Toshiyuki Uehara
Tomoyuki Ohara
Kazunori Toyoda
Kazuyuki Nagatsuka
Kazuo Minematsu
Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries
Cerebrovascular Diseases Extra
Acute ischemic lesions
Carotid artery
Intracranial artery
Ischemic stroke
Stenosis
Transient ischemic attack
author_facet Toshiyuki Uehara
Tomoyuki Ohara
Kazunori Toyoda
Kazuyuki Nagatsuka
Kazuo Minematsu
author_sort Toshiyuki Uehara
title Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries
title_short Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries
title_full Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries
title_fullStr Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries
title_full_unstemmed Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries
title_sort clinical, laboratory, and imaging characteristics of transient ischemic attack caused by large artery lesions: a comparison between carotid and intracranial arteries
publisher Karger Publishers
series Cerebrovascular Diseases Extra
issn 1664-5456
publishDate 2015-10-01
description Background/Aims: The aims of this study were to determine the differences in clinical characteristics and the risk of ischemic stroke between patients with transient ischemic attack (TIA) attributable to extracranial carotid and intracranial artery occlusive lesions. Methods: Among 445 patients admitted to our stroke care unit within 48 h of TIA onset between April 2008 and December 2013, 85 patients (63 men, mean age 69.4 years) with large artery occlusive lesions relevant to symptoms were included in this study. The primary endpoints were ischemic stroke at 2 and 90 days after TIA onset. Results: Twenty-eight patients had carotid artery occlusive lesions (extracranial group), and 57 patients had intracranial artery occlusive lesions (intracranial group). Patients in the intracranial group were significantly younger, had lower levels of fibrinogen, and were less likely to have occlusion when compared with those in the extracranial group. Eleven patients in the extracranial group and none in the intracranial group underwent revascularization procedures within 90 days of TIA onset. The 2-day risk (14.2 vs. 0%, p = 0.044) and the 90-day risk (17.1 vs. 0%, p = 0.020) of ischemic stroke after TIA onset were significantly higher in the intracranial group than in the extracranial group. Conclusions: Among our patients with TIA caused by large artery disease, patients with intracranial artery occlusive lesions were more frequent and were at higher risk of early ischemic stroke than those with extracranial carotid artery occlusive lesions. These data highlight the importance of prompt assessment of intracranial artery lesions in patients with TIA.
topic Acute ischemic lesions
Carotid artery
Intracranial artery
Ischemic stroke
Stenosis
Transient ischemic attack
url http://www.karger.com/Article/FullText/440731
work_keys_str_mv AT toshiyukiuehara clinicallaboratoryandimagingcharacteristicsoftransientischemicattackcausedbylargearterylesionsacomparisonbetweencarotidandintracranialarteries
AT tomoyukiohara clinicallaboratoryandimagingcharacteristicsoftransientischemicattackcausedbylargearterylesionsacomparisonbetweencarotidandintracranialarteries
AT kazunoritoyoda clinicallaboratoryandimagingcharacteristicsoftransientischemicattackcausedbylargearterylesionsacomparisonbetweencarotidandintracranialarteries
AT kazuyukinagatsuka clinicallaboratoryandimagingcharacteristicsoftransientischemicattackcausedbylargearterylesionsacomparisonbetweencarotidandintracranialarteries
AT kazuominematsu clinicallaboratoryandimagingcharacteristicsoftransientischemicattackcausedbylargearterylesionsacomparisonbetweencarotidandintracranialarteries
_version_ 1724521863864909824