• Title/Summary/Keyword: transient ischemic attack

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Factors Influencing the Changes of BAEPs in Vertebrobasilar Transient Ischemic Attacks (추골기저동맥 일과성 허혈발작에서 뇌간청각유발전위변화에 영향을 미치는 인자)

  • Park, Young Hyuk;Yoo, Bong Goo;Kim, Kwang Soo;Yoo, Kyung Moo
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.101-106
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    • 2000
  • Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.

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Focal Subarachnoid Hemorrhage Mimicking Recurrent Transient Ischemic Attack (반복적인 유사 일과성 허혈발작을 보인 국소거미막하출혈)

  • Jeong, Byoung-Min;Ryu, Han Uk;Kang, Mi-Kyoung;Kang, Jin-Ju;Seo, Man-Wook;Oh, Sun-Young;Shin, Byoung-Soo
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.314-317
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    • 2018
  • Focal subarachnoid hemorrhage occasionally presents as transient focal neurologic episodes mimicking transient ischemic attack (TIA). Unless properly diagnosed, it may aggravate cerebral hemorrhage by administering antithrombotic agents. Therefore, clinicians need to be aware that such focal subarachnoid hemorrhage sometimes cannot be detected on noncontrast computed tomography and blood-sensitive magnetic resonance imaging can detect even a small amount of hemorrhage. We describe an 85-year-old woman with focal subarachnoid hemorrhage and possible cerebral amyloid angiopathy who presented transient left arm weakness recurrently, which mimicked TIA.

Urgent Recanalization with Stenting for Severe Intracranial Atherosclerosis after Transient Ischemic Attack or Minor Stroke

  • Park, Tae-Sik;Choi, Beom-Jin;Lee, Tae-Hong;Song, Joon-Suk;Lee, Dong-Youl;Sung, Sang-Min
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.322-326
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    • 2011
  • Objective : Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. Methods : Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. Results : Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). Conclusion : Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ${\geq}$ 70%.

Clinical characteristics and outcomes in patients with lesion-positive transient ischemic attack

  • Kang, Su-Jeong;Lee, Sang-Gil;Yum, Kyu Sun;Kim, Ji-Seon;Lee, Sung-Hyun;Lee, Sang-Soo;Shin, Dong-Ick
    • Journal of Biomedical and Translational Research
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    • v.19 no.4
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    • pp.110-115
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    • 2018
  • Transient ischemic attack (TIA) indicates high risk for major stroke and is considered a medical emergency. Diffusion-weighted imaging (DWI) enables detection of acute ischemic lesions. The clinical significance of DWI positive lesions in TIA is obscure and its prevalence, clinical features are not established. Therefore, we performed a clinical, etiological and prognostic analysis through a cross-sectional analysis of 235 TIA patients, grouped according to presence of DWI lesion. Clinical features, underlying risk factors for stroke, outcome and rate of recurrence were analyzed. 3 months follow-up of modified Rankin Scales (mRS) were done with telephone survey. DWI positive lesions were present in 14.0% of patients. Etiological factors significantly associated with DWI lesions in TIA patients were male sex (p = 0.038), stroke history (p = 0.012) and atrial fibrillation (p < 0.001). Presence of at least one medium or high risk of cardioembolism from TOAST classification were not associated with lesions when excluding association to atrial fibrillation (p = 0.108). Clinical features showed no significant difference. Whether the patients had lesion-positive DWI was not related to an increase in mRS score during the hospital stay or at the 3-month follow-up after discharge. Future studies should include multi-center samples with large numbers, considering each unique medical environment. Routine acquisition of follow-up DWI for proper evaluation of the tissue-based definition of TIA should also be considered.

A Case Report of a TIA Patient with Severe MCA Stenosis (Severe MCA Stenosis로 인한 TIA 환자 1례)

  • Yoon, Chang-Joon;Kim, Jong-Hwa;Lee, Soo-Gil
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.54-58
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    • 2008
  • Transient Ischemic Attack(TIA) is an important risk factor of stroke but often underestimated by clinicians. In this case, we administered oriental-western cooperative therapy to a 72 years old female TIA patient with severe MCA stenosis. After treatment, all symptoms were disappeared and has not reappeared until 1 year follow-up.

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A Case Study of a Taeyangin Patient with Vertebrobasilar Insufficient after Mistreat as Taeeumin. (태음인으로 오치(誤治)한 추골뇌저동맥부전증 태양인 환자 치험 1례)

  • Kang, Seok-Hwan;Jeon, Soo-Hyung;Na, Young-Ju;Kim, Jong-Won
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.4
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    • pp.338-349
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    • 2016
  • Objectives This case study was about a Taeyangin patient with transient ischemic attack(TIA) due to vertebrobasilar insufficiency(VBI). In this study, we report the progress of mistreat with Taeyangin as Taeeumin and the improvement of symptoms after rediagnosis as Taeyangin. Methods Patient's chief complain was weakness of lower limbs, dysarthria and dizziness. Patient first time took Taeeumin prescription such as Chunghyulganggi-tang, Chunsimyonja-tang and Sanyakbopaewon-tang. After occuring side effects we changed the prescription to Taeyangin herbal medicine such as Ogapijangchuk-tang gagam and Mihudeungsikjang-tang gagam. Result and Conclusion Patient suffered from diarrhea by taking Taeeumin prescription and symptom was continue. After changing of prescription to Taeyangin herbal medicine, not only chief symptom but also original symptom was improved.

A Comparative Study between First Attack and Reattack Groups in C.V.A (중풍환자의 초발군과 재발군에 관한 임상적 고찰)

  • 박숙자;권정남;김영균
    • The Journal of Korean Medicine
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    • v.23 no.3
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    • pp.119-133
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    • 2002
  • Objectives : This study was designed to investigate significant differences between the first attack and reattack groups to form fundamental data for decreasing recurrence and secondary prevention of stroke. Methods : I studied 204 patients admitted within 7 days of onset, after the diagnosis of stroke, in the Oriental Medical Hospital of Dongeui University from February to July in 2001.compared the reattack group with the first attack group for risk factors, clinical symptoms and progress, average mark and degree of improvement in Activity Index. Results : 1. Meaningful risk factors associated with the reattack group were male sex, a past history of hypertension and transient ischemic attack, and a family history of stroke. 2. The reattack group had conscious or cognitive disorder in early stage of onset, dysphagia, constipation, urinary incontinence, visual field defect in acute stage, high blood pressure and tachycardia in abnormalvital sign in acute stage, neuropsychosis, shoulder pain and rigidity, and pneumonia in complications more than the first attack group. 3. In Activity Index, the average mark of reattack group was lower than that of the first stroke group and improvement of the reattack group was delayed compared with the first attack group. Conclusions : The reattack group had more severe symptoms and clinical progress than the first attack group.

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Impact of Asymmetric Middle Cerebral Artery Velocity on Functional Recovery in Patients with Transient Ischemic Attack or Acute Ischemic Stroke (일과성허혈발작 및 급성뇌경색환자에서 경두개도플러로 측정된 중간대뇌동맥 비대칭 지수가 환자 예후에 미치는 영향)

  • Han, Minho;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.2
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    • pp.126-135
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    • 2018
  • This study examined whether the difference in the middle cerebral artery (MCA) velocities can predict the prognosis of stroke and whether the prognostic impact differs among stroke subtypes. Transient ischemic attack (TIA) or acute ischemic stroke patients, who underwent a routine evaluation and transcranial Doppler (TCD), were included in this study. The MCA asymmetry index was calculated using the relative percentage difference in the mean flow velocity (MFV) between the left and right MCA: (|RMCA MFV-LMCA MFV|/mean MCA MFV)${\times}100$. The stroke subtypes were determined using the TOAST classification. Poor functional outcomes were defined as a mRS score ${\geq}3$ at 3 months after the onset of stroke. A total of 988 patients were included, of whom 157 (15.9%) had a poor functional outcome. Multivariable analysis showed that only the MCA asymmetry index was independently associated with a poor functional outcome. ROC curve analysis showed that adding the MCA asymmetry index to the prediction model improved the discrimination of a poor functional outcome from acute ischemic stroke (from 88.6% [95% CI, 85.2~91.9] to 89.2% [95% CI, 85.9~92.5]). The MCA asymmetry index has an independent prognostic value for predicting a poor short-term functional outcome after an acute cerebral infarction. Therefore, TCD may be useful for predicting a poor functional outcome in patients with acute ischemic stroke.

Preventive effects of ginseng against atherosclerosis and subsequent ischemic stroke: A randomized controlled trial (PEGASUS trial)

  • Kwon, Boseong;Song, Yunsun;Kim, Joong-Goo;Lee, Dongwhane;Lee, Sang-hun;Cho, Young-Keol;Kim, Jong S.;Suh, Dae Chul
    • Journal of Ginseng Research
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    • v.46 no.4
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    • pp.585-591
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    • 2022
  • Background: Korean Red Ginseng (KRG) extract has been shown to have beneficial effects in patients with atherosclerosis, suggesting that KRG extract may be effective in preventing subsequent ischemic stroke in patients with severe atherosclerosis. Methods: This double-blind, placebo-controlled trial randomized patients with severe atherosclerosis in major intracranial arteries or extracranial carotid artery, to ginseng group and placebo group. They were given two 500-mg KRG tablets or identical placebo tablets twice daily for 12 months according to randomization. The primary endpoint was the composite of cerebral ischemic stroke and transient ischemic attack during 12 months after randomization. The secondary endpoints were change in volumetric blood flow of the intracranial vessels and the incidence of newly developed asymptomatic ischemic lesions. Any adverse events were monitored. Results: Fifty-eight patients were randomized from June 2016 to June 2017, 29 to ginseng and 29 to placebo, and 52 (28 and 24, respectively) completed the study. One patient in the placebo group, but none in the ginseng group, experienced ischemic symptoms (p = 0.46). Changes in volumetric blood flow and the presence of ischemic brain lesions did not differ significantly in the two groups, and none of these patients experienced adverse drug reactions. Conclusion: Ginseng was well tolerated by patients with severe atherosclerosis, with these patients showing good compliance with ginseng dosing. Ginseng did not show significant effects compared with placebo, although none of the ginseng-treated patients experienced ischemic events. Long-term studies in larger patient populations are required to test the effect of ginseng.

The Risk Factors of Recurrent Ischemic Stroke (허혈성 뇌졸중의 재발과 연관된 위험인자)

  • Jung, Cheol;Kim, Wook-Nyneon;Kim, Min-Jeung;Choi, Soek-Mum;Eur, Kyung-Yoon;Park, Mee-Young;Hah, Jeng-Sang;Byun, Yeung-Ju
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.423-431
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    • 1993
  • To eveluate the risk factors which are related to recurrence of ischemic stroke, we selected subjects who were admitted to YNUH due to recurrent stroke and compared their risk factors with non-recurred group who suffered from single ischemic stroke. In the subjects, 55 of them are men and 22 were women and in the non-recurred groups, 84 of them were men and 40 were women, Subject's age ranged from 29 to 85 years(Mean 62, 5years), and non-recurred group's age ranged from 27 to 90 years(Mean 60, 7years), Peak incidence of ischemic stroke is in the 7th decade in both groups. Age and sex are not, statistically significant for recurrence of ischemic stroke. The patient's history of diabetes mellitus, myocardial infarction, atrial fibrillation, transient attack and type or site of ischemic stroke had no significant effect statistically on the recurrent ischemic stroke. However, when the patient had previous history of hypertension or systolic blood pressure more than 160mmHg and diastolic more than 95mmHg, there was substantial difference(P<0.05) between the two group in the recurrence of ischemic stroke. According to the above results, hypertension is most likely significant risk factor of the recurrence of ischemic stroke within 2years after initial one. Therefore, adequate treatment of the hypertension is important for the prevention of ischemic stroke. Further study is required for searching other risk factors.

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