Unruptured aneurysms in patients with transient ischemic attack or reversible ischemic neurological deficit

1989 ◽  
Vol 91 (3) ◽  
pp. 229-233 ◽  
Author(s):  
Kikuo Ohno ◽  
Ryuta Suzuki ◽  
Hiroyuki Masaoka ◽  
Yoshiharu Matsushima ◽  
Sciji Monma ◽  
...  
2014 ◽  
Vol 01 (01) ◽  
pp. 039-042
Author(s):  
Arun Garg ◽  
Abdul Muniem ◽  
Sushant Bhuyan ◽  
Atma Bansal

AbstractTransient ischemic attack (TIA) is defined as a temporary focal neurological deficit of presumed vascular origin, lasting for less than 1 h, with no evidence of infarct on neuroimaging. If a patient is suffering from multiple cardiovascular risk factors and presents with transient and recurrent focal neurological deficits, the most likely diagnosis considered is TIA. As the possibility of stroke within first 24 h is high, such patients need aggressive investigation and management, and ideally should be hospitalized. TIA usually occurs due to major intracranial or extra cranial artery stenosis. However, if vascular imaging and cardiac workup is normal, possibility of small vessel disease is considered. Space occupying lesions usually presents with seizure, symptoms of raised intracranial pressure or progressive neurological deficits rather than TIA. There are a few case reports where meningioma presented as TIA, due to vascular compromise by encasing internal carotid artery. 1,2 transient focal neurological deficits can have other differentials like post ictal palsy and negative motor seizures. In a given patient with space occupying lesion like meningioma presenting with recurrent transient focal neurological deficits we need to consider all these differentials. We are hereby reporting a case of convexity meningioma, which presented as recurrent focal neurological deficit due to negative motor seizures, mimicking transient ischemic attack.


1996 ◽  
Vol 10 (4) ◽  
pp. 231-232 ◽  
Author(s):  
Sander Jo Veldhuyzen van Zanten ◽  
C William McCormick

Ticlopidine hydrochloride has been shown to reduce the risk of first or recurrent stroke in patients who have experienced a transient ischemic attack, reversible ischemic neurological deficit, recurrent stroke or first stroke. Severe liver dysfunction is a contraindication for its use. Increase in liver enzymes has been reported with use of this drug, but jaundice is rare. A case of severe ticlopidine-induced hepatitis that was associated with a marked increase in antinuclear antibody (ANA) levels is reported. Physicians prescribing ticlopidine hydrochloride should be aware that a potentially severe acute hepatitis associated with ANA positivity can occur. The drug should be discontinued if signs of liver dysfunction occur.


Author(s):  
Francois Moreau ◽  
Thomas Jeerakathil ◽  
Shelagh B. Coutts ◽  

Background:The presence of residual neurological deficits after neurological symptoms is important information for making a diagnosis of Transient Ischemic Attack (TIA) versus stroke. The purpose of this study was to establish the reliability of the referring physician (non neurologist) to report focal neurological deficits in the context of an urgent referral for TIA.Methods:Prospectively recorded urgent physician-to-physician phone referrals for TIA through the Southern Alberta TIA hotline from March 2009 to July 2010 were reviewed. “Has the neurological deficit completely resolved?” was asked to the referring physician (family or emergency room physician) and recorded prospectively as a yes/no response. Patients were included if a neurological examination was performed by a neurologist on the same day as referral. The neurologist's assessment of whether the deficit had resolved was compared to that of the referring physician.Results:78 patients were included in this study. 62 patients had resolved as per the referring physician's assessment. Of these 62 patients, 16 (25.8% 95%CI 16-38) had evidence of persisting neurological deficits on the neurologist's assessment. A wide variety of mild neurological deficits were identified. None of these deficits appeared to be explained by progression of symptoms.Conclusion:Physicians referring patients with TIA syndromes for emergent assessment do not reliably detect mild residual deficits in one-quarter of patients. We are questioning the validity of neurological deficit resolution as a triage rule. The findings suggest that studies of TIA likely include a proportion of minor stroke patients and this should be remembered when extrapolating the results to other populations.


BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xianyue Liu ◽  
Ke Han ◽  
Mingyi Hu ◽  
Huanquan Liao ◽  
Qinghua Hou

Abstract Background Transient ischemic attack (TIA) is a brief episode of cerebral ischemia. However, if a symptom is not presented as drop attack or hemiplegia, and alarming to the patient and the physician, how short of a symptom duration would raise the concern of a physician for TIA? It will be more complicated if the location of the neurological deficit is vagrant. This report highlights a rare TIA case which presented a very short duration of migratory patchy distribution numbness. Case presentation A middle-aged gentleman was presented with recurrent patchy distribution numbness on the right side of the body for 2 months, with the episode lasting as short as about 10 s. The location of the numbness was erratic and migratory. Magnetic resonance angiography (MRA) revealed mild stenosis on the left middle cerebral artery (MCA). Transcranial Doppler (TCD) micro-emboli monitoring detected positive micro-emboli signals (MES), leading to the confirmation of a TIA diagnosis. After a standard dual antiplatelet treatment combined with enhanced lipid reduction therapy with statins, MES disappeared on dynamic TCD emboli monitoring, and no more episodes of TIA have been noticed on the follow-ups. Conclusion TIA caused by micro-emboli can display as recurrent migratory neurological deficit within seconds. TCD micro-emboli monitoring is very helpful to differentiate this situation from TIA mimics with follow-ups, as well as to locate unstable plague.


2017 ◽  
Vol 48 (S 01) ◽  
pp. S1-S45
Author(s):  
N. Plesko-Altermatt ◽  
S. Grunt ◽  
M. Diepold ◽  
E. Perret-Hoigné ◽  
T. Horvath ◽  
...  

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