The duration of symptoms in transient ischemic attack.

Abstract

The majority of TIAs last from 2 to 15 minutes, although some may be of long duration. We examined factors related to the duration of TIAs to identify the relationship to clinical characteristics. We performed brain imaging studies as well as angiographic and cardiac examinations in 81 consecutive patients (64 men and 17 women, age 65.8+/-9.9 years) with carotid TIAs. We evaluated risk factors (hypertension, diabetes mellitus, hyperlipidemia, alcohol consumption, and smoking), potential cardiac sources of emboli, and arterial stenosis > or =50% in diameter in the carotid or middle cerebral arteries. Recent infarcts were assessed with CT or MRI. We correlated duration of symptoms with clinical data. The presence of emboligenic cardiac or arterial diseases was significantly related to the duration of symptoms. With sensitivity-specificity curve analysis for detecting such diseases, the duration of symptoms could be divided into short-duration TIAs (<60 minutes, n = 41) or long-duration TIAs (> or =60 minutes, n = 40). Patients with long-duration TIAs had emboligenic cardiac or arterial diseases more frequently than those with short-duration TIAs (86% versus 46%, p < 0.001). Recent infarcts were also more frequent in patients with long-duration TIAs than they were in patients with short-duration TIAs (45% versus 21%, p < 0.05). Short-duration and long-duration TIAs can be separated based on symptom duration of < 1 hour or > or = 1 hour. Patients with long-duration TIAs should be examined more closely for the presence of cardiac and arterial diseases than those with short-duration TIAs.