This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sempere, A. P. Articles by Clavería, L. E. Search for Related Content PubMed PubMed Citation Articles by Sempere, A. P. Articles by Clavería, L. E. Pubmed/NCBI databases Medline Plus Health Information Transient Ischemic Attack

(Stroke. 1998;29:40-45.)
© 1998 American Heart Association, Inc.

Original Contributions

Etiopathogenesis of Transient Ischemic Attacks and Minor Ischemic Strokes

A Community-Based Study in Segovia, Spain

Angel P. Sempere, MD; Jacinto Duarte, MD; Carmen Cabezas, MD; Luis Erik Clavería, MD

From the Department of Neurology, Segovia General Hospital (Spain).

Correspondence to Angel Pérez Sempere, PO Box 43 (Aptdo 43), 03800 Alcoy, Spain. E-mail aperezs{at}meditex.es

Background and Purpose—We sought to analyze the etiology and underlying vascular risk factors of transient ischemic attacks (TIAs) and minor ischemic strokes (MISs).

Methods—We prospectively studied the vascular risk factors and etiologic categories in 235 patients with TIAs and MISs from a community-based register in a rural area of Spain. Five etiologic categories were considered: (1) cardioembolism, (2) large-artery atherosclerosis, (3) small-artery disease, (4) other etiologies, and (5) undetermined etiology. Systematic investigations included neuroimaging (CT/MRI) and vascular studies (duplex scan/MR angiography and angiography in selected cases).

Results—The two most frequent etiologic categories were small-artery disease (31%) and cardioembolism (26%). Large-artery atherosclerosis was detected in 11% of the patients. Significant carotid stenosis (50%) was present in 13% of patients with carotid territory events. No cause could be found or it was uncertain in almost one third of the patients. The distribution of etiologic categories was similar in TIAs and MISs. The most prevalent vascular risk factors were as follows: arterial hypertension (50%), smoking (26%), atrial fibrillation (20%), hypercholesterolemia (17%), diabetes (15%), ischemic heart disease (12%), and peripheral vascular disease (3%). Carotid bruits were detected in 3% of the patients.

Conclusions—An etiologic classification of TIAs and MISs is feasible. The two most frequent pathogenetic mechanisms in our study were small-artery disease and cardioembolism. The prevalence of large-artery atherosclerosis was low.

Key Words: atherosclerosis • carotid arteries • cerebral ischemia, transient • etiology • risk factors

This article has been cited by other articles:

				M. Correia, M. R. Silva, R. Magalhaes, L. Guimaraes, and M. Carolina Silva Transient Ischemic Attacks in Rural and Urban Northern Portugal: Incidence and Short-Term Prognosis Stroke, January 1, 2006; 37(1): 50 - 55. [Abstract] [Full Text] [PDF]

				C. Weimar, K. Kraywinkel, J. Rodl, A. Hippe, L. Harms, A. Kloth, H.-C. Diener, and for the German Stroke Data Bank Collaborators Etiology, Duration, and Prognosis of Transient Ischemic Attacks: An Analysis From the German Stroke Data Bank Arch Neurol, October 1, 2002; 59(10): 1584 - 1588. [Abstract] [Full Text] [PDF]

				G. E. Mead, S. C. Lewis, J. M. Wardlaw, and M. S. Dennis Comparison of Risk Factors in Patients With Transient and Prolonged Eye and Brain Ischemic Syndromes Stroke, October 1, 2002; 33(10): 2383 - 2390. [Abstract] [Full Text] [PDF]

				M. J. Kupferminc, D. Yair, N. M. Bornstein, J. B. Lessing, and A. Eldor Transient Focal Neurological Deficits During Pregnancy in Carriers of Inherited Thrombophilia Stroke, April 1, 2000; 31(4): 892 - 895. [Abstract] [Full Text] [PDF]