Abstract
In this journal club article, we evaluate a study by Giles and colleagues1 that reports stroke risk in patients with classically defined TIA subcategorized by presence or absence of radiologic brain infarction. The concept of a TIA is evolving in parallel with better understanding of brain ischemia and insights gained from neuroimaging studies. TIAs were classically defined as a sudden focal neurologic deficit resulting from brain or retinal ischemia lasting less than 24 hours.2,3 The time threshold of 24 hours was arbitrarily chosen, and given that there is no evidence to support any single time criterion associated with infarction, this has appropriately been questioned. A newer and well-received definition of TIA is “a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.”4 This definition communicates the important concept that transient symptoms can nonetheless be associated with permanent brain injury, encourages the use of neuroimaging studies, and may promote rapid interventions for acute brain ischemia. The ABCD2 score, a risk-stratifying score for patients with TIA, is derived from the patient's age, blood pressure, clinical features, TIA duration, and history of diabetes. This simple, validated score identifies patients at highest risk of early stroke after TIA.5 Scores are commonly divided into low risk (0–3), intermediate risk (4–5), and high risk.6,7 The clinical ABCD2 scale is integrated in this study with results from acute brain imaging to assess how the new tissue-based definition of TIA further assists with risk stratification of patients with transient neurologic symptoms. In this analysis of data pooled from 12 medical centers which included 4,574 patients, Giles and colleagues subcategorized TIA as “tissue positive” or “tissue negative,” depending on the presence or absence of radiographic brain infarction seen on MRI or CT …
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
