The Review of Transient Ischemic Attack Patients: An Experience of a Clinic about Diagnosis and Follow-up

Objectives: Transient Ischemic Attack (TIA) is due to a temporary lack of adequate blood and oxygen to the brain. TIAs typically last less than 24 hours. 10-15% of ischemic stroke patients have a history of TIA. 18% of them experience an ischemic stroke within 90 days, and the ABCD2 scoring system is used to estimate the risk. Our study aims to investigate the risk factors, the etiology, the lesion occurrence on MRI and the near-term risk of stroke of patients on whom TIA was diagnosed.
Methods: In this study, 124 patients were included between January 2012 and January 2018. Sixty-eight of the 124 patients were male. The history of patients was questioned; systemic and neurological examinations were made. The stroke risk factors and TIA duration were noted and ABCD2 scores were calculated. All the patients’ blood samples, including glucose and lipid profile, were studied. They received CT, DWI MRI, electrocardiography, transthoracic echocardiography, ultrasound and/or MR angiography of the cervical arteries.
Results: One hundred twenty-four patients were included in this study, and 56 patients were female. The mean age was 63.04±16.77. Hypertension was the most common risk factor (50.8%). Twenty-seven patients were on antithrombotic; six patients were on anticoagulant therapy, while 91 patients were not receiving any antiaggregan therapy. ABCD2 scores were significantly higher on the antithrombotic therapy group (p=0.019). In 52 patients ABCD2 score was below 4, and in 72 patients, the score was greater than 4. In 67.7% of patients, no etiology was found. An ischemic lesion was detected in 16.9% of the patients. 58 % of the patients were discharged on anticoagulant therapy. Five patients developed ischemic stroke.
Conclusion: The risk factors of ischemic stroke and TIAs are similar factors. The etiology of TIAs cannot be found out in most of the patients. Thus, the patients are discharged with oral anticoagulant treatment.

Geçici iskemik atakli hastalarin gözden geçirilmesi; tani ve takipte bir klinik deneyimi

Amaç: Geçici iskemik atak (GÝA); akut, fokal serebral veya monooküler disfonksiyona ait kýsa süreli semptomlarla karakterize olan genel olarak 24 saatten kýsa süren epizodlardýr.Ýskemik inme geçiren hastalarýn % 10-15’nin öyküsünde GÝA vardýr (3-6). Bu hastalarýn % 18’i ilk 3 ay içinde inme geçirirken ABCD2 skorlamasý ile hastalardaki yakýn dönem inme riski belirlenebilmektedir. Çalýþmamýzýn amacý GÝA hastalarýnda risk faktörlerini ortaya koymak, etyolojiyi ve lezyon varlýðýný belirlemek, hastalarýn 90 günlük takipleri boyunca geliþmiþ inme oranýný saptamaktýr.
Gereç ve Yöntem: Çalýþmaya Ocak 2012- Ocak 2018 tarihleri arasýnda, yaþlarý 29-93 arasýnda deðiþen 68’i (%54.8) erkek toplam 124 GÝA hastasý alýndý. Hastalarýn anamnezleri alýnarak, nörolojik ve sistemik muayeneleri yapýldý. Hastalarýn GÝA süresi, risk faktörleri kaydedildi, ABCD2 skorlarý hesaplandý. Tüm hastalarýn açlýk kan glukoz düzeyi, lipid deðerlerine bakýldý. BBT ve DWI Beyin MR çekildi. Tüm hastalara Elektrokardiyografi, transtorasik Ekokardiyografi, karotis ve vertebral arter dopler ultrasonografi ve/veya MR anjiografi çekildi.
Bulgular: Çalýþmaya 56’sý kadýn toplam 124 hasta alýndý, hastalarýn yaþ ortalamasý 63.04 ±16.77 ‘di. Hipertansiyon en fazla görülen risk faktörüydü (% 50.8). 91 hasta (%73.4) herhangi bir antiagregan tedavi almazken, 27 hasta antitrombotik tedavi, 6’sý antikoagülan tedavi almaktaydý. Antitrombotik tedavi alanlarýn ABCD2 skorlarý anlamlý olarak yüksek tespit edildi (p=0,019). 52 hastanýn ABCD2 skoru 4’ün altýnda, 72 hastanýn ≥4 bulundu. % 67.7 hastada etyoloji belirlenemedi. Hastalarýn % 16.9’unda akut iskemik lezyon tespit edildi. Hastalarýn % 58’i oral antikoagülan tedavi ile taburcu edildi. 5 hastanýn tekrarlayan iskemik inme geçirdiði gözlendi.
Sonuçlar: GÝA ta iskemik inme ile benzer risk faktörleri mevcuttur, çoðu hastada etyoloji belirlenememekte hastalar en sýk oral antikoagülan tedavi ile taburcu olmaktadýr. (SETB-2018-02-027)