The Duration of Symptoms in Transient Ischemic Attacks


ABSTRACT: BACKGROUND: The better understanding of the pathophysiology of brain ischemia ,the newer look provided by the increasingly available imaging techniques ,and the promising thrombolytic therapy have made the classical 24 hours time limit definition of Transient Ischemic Attack(TIA) outdated. A newer 1 hour time limit has recently been proposed and seems to be reasonable. OBJECTIVE: This study was designed to show the different aspects of TIA in relation to risk factors and imaging findings. DESIGN AND SETTING: A prospective study, patients were received at the neurology consulting clinic, examined clinically and by a set of investigations. PATIENTS AND METHODS:32 consecutive patients with TIA of variable duration and presentation were clinically examined within variable intervals from onset of symptoms by means of a specially designed questionnaire followed by a list of investigations including imaging of the brain within 4 weeks of the onset of symptoms. RESULTS: Most TIAs last less than ten minutes (18/32, 56.25% of all). Patients with longer duration TIAs found to have higher incidence of abnormalities in brain imaging than short duration ones .Most of patients with TIA have more than one attack of TIA on presentation and patients with multiple TIAs have less incidence of cardiac disease than those who have single prolonged TIA. CONCLUSION: Most TIAs last less than 10 minutes. The longer the duration of the symptoms, the higher the frequency of recent infarcts detected by brain imaging. MRI of the brain is much more sensitive than head CT-SCAN in the detection of changes in patients who present with TIA .Patients with brief duration TIAs may not seek for medical help until they are recurrent while those patients with longer duration TIAs ask for medical advice early