Limb shaking transient ischemic attacks: A follow-up of 28 patients

✓ Moyamoya disease is a chronic occlusive cerebrovascular disease of unknown etiology for which no effective treatment has been found. The authors report the results of 23 superficial temporal-middle cerebral artery (STA-MCA) anastomoses and seven encephalomyosynangioses, performed on 13 cases with moyamoya disease and on four additional atypical cases. There were 10 children and seven adults in this study. The follow-up period ranged from 1 year and 4 months to 4 years and 1 month postoperatively; nine patients had excellent results, five good, and one fair; two patients were unchanged. The anastomotic procedure was most effective for transient ischemic attacks, reversible ischemic neurological deficits, and even minor or moderate neurological symptoms. The STA-MCA anastomosis appears to be an effective treatment for moyamoya disease.

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Limb-shaking transient ischemic attacks: Two case reports with unusual pathogenesis

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/s1052-3057(10)80194-6 ◽

1995 ◽

Vol 5 (4) ◽

pp. 232-234

Author(s):

M. Yeung ◽

D.W. Gross ◽

A. Shuaib

Keyword(s):

Case Reports ◽

Transient Ischemic Attacks ◽

Limb Shaking

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High-Flow Extracranial-to-Intracranial Excimer Laser–Assisted Nonocclusive Anastomosis Bypass for Symptomatic Carotid Artery Occlusion

Neurosurgery ◽

10.1227/neu.0b013e318214e2e7 ◽

2011 ◽

Vol 68 (6) ◽

pp. 1687-1694 ◽

Cited By ~ 11

Author(s):

Tristan P.C. van Doormaal ◽

Catharina J.M. Klijn ◽

Perry T.C. van Doormaal ◽

L. Jaap Kappelle ◽

Luca Regli ◽

...

Keyword(s):

Ischemic Stroke ◽

Carotid Artery ◽

Bypass Surgery ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

High Flow ◽

Transient Ischemic Attacks ◽

Mean Flow ◽

Symptomatic Carotid

Abstract BACKGROUND: A high-flow bypass is theoretically more effective than a conventional low-flow bypass in preventing strokes in patients with symptomatic carotid artery occlusion and a compromised hemodynamic state of the brain. OBJECTIVE: To study the results of excimer laser-assisted nonocclusive anastomosis (ELANA) high-flow extracranial-to-intracranial (EC-IC) bypass surgery in these patients. METHODS: Between August 1998 and May 2008, 24 patients underwent ELANA EC-IC bypass surgery because of transient ischemic attacks or minor ischemic stroke associated with carotid artery occlusion. We retrospectively collected information. Follow-up data were updated by structured telephone interviews between May and September 2008. RESULTS: In all patients, the ELANA EC-IC bypass was patent at the end of surgery with a mean flow of 106 ± 41 mL/min. Within 30 days after the operation, 22 patients (92%) had no major complication, whereas 2 patients (8%) had a fatal intracerebral hemorrhage. During follow-up of a mean 4.4 ± 2.4 years, the bypass remained patent in 18 of the 22 surviving patients (82%) with a mean flow of 141 ± 59 mL/min. All patients with a patent bypass remained free of transient ischemic attacks and ischemic stroke. In 4 patients, the bypass occluded, accompanied by ipsilateral transient ischemic attacks in 2 patients, ipsilateral ischemic stroke in 1 patient, and contralateral ischemic stroke in another patient. CONCLUSION: ELANA EC-IC bypass surgery in patients with carotid artery occlusion is technically feasible and results in cessation of ongoing transient ischemic attacks and minor ischemic strokes, but carries a risk of postoperative hemorrhage.

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The Effect of a Platelet Inhibiting Drug (Sulfinpyrazone) in the Therapy of Patients with Transient Ischemic Attacks (Tia’s) and Minor Strokes

10.1055/s-0039-1689445 ◽

1975 ◽

Author(s):

J. T. Robertson ◽

M. Dugdale ◽

N. Salky ◽

H. Robinson

Keyword(s):

Risk Factors ◽

Platelet Aggregation ◽

Routine Laboratory ◽

Transient Ischemic Attacks ◽

Double Blind ◽

Survival Studies ◽

A Minor ◽

Cerebrovascular Occlusive Disease ◽

Subsequent Failure

A prospective double blind randomized trial of sulfinpyrazone and placebo is described in patients with TIA’S and minor strokes. The criteria for entry into the Study were patients with at least two transient ischemic attacks within a two-week period or patients with a minor fixed neurological deficit resulting from cerebrovascular occlusive disease. All patients had routine laboratory, special platelet aggregation studies, and cerebral arteriography. Several had initial and subsequent platelet survival studies. To insure equivalence of the two groups, patients were randomly assigned to categories reflecting their risk factors and age. Patients were followed every three months with appropriate laboratory and platelet studies. Interval follow-up occured when side effects or additional symptoms appeared.When patients failed on sulfinpyrazone, they were placed on sulfinpyrazone and Coumadin. Patients who failed on placebo were placed on sulfinpyrazone followed by sulfinpyrazone and Coumadin if subsequent failure occured. Failure was defined as two transient ischemic attacks within a two-week period or an additional stroke syndrome.New patients will be enrolled for three years, and all patients will be followed for five years. All data is incorporated into computer files.Preliminary results relating to the first sixty patients will be presented.

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