ZusammenfassungDas Thema hitzebedingter Erkrankungen ist in den letzten Jahren mit überaus heißen Sommern und häufigen Hitzewellen immer relevanter geworden. Epidemiologisch lassen sich solche Erkrankungen nur schwer fassen, da sie saisonal vorkommen und überwiegend besonders exponierte Patienten betreffen. Fatale Verläufe wie der im Beitrag beschriebene sind äußerst selten 1.

BackgroundTransient ischemic attack (TIA) is an important predictor for a pending stroke. Guidelines recommend similar workup for TIA-patients as for stroke patients to directly assess the extra- and intracranial arteries via Computed tomography angiography (CTA) regarding vascular pathologies with direct therapeutic implications. Aim of our study was a systematic analysis of CTA-findings in TIA-patients and evaluate possible predictive TIA scores for ipsilateral vascular pathology.MethodsWe analysed data from TIA patients admitted to our University Medical Centre, between September 2015 and March 2018. Following subgroups were identified: 1) no- or low-grade-stenosis (<50%) 2) ipsilateral high-risk vascular pathology and 3) high risk findings needing surgical or interventional treatment. As predictive tools for ipsilateral vascular findings we used the ABCD2-, the ABCD3- and the SPI-II score.ResultsOf 833 patients, 549 (65.9%) underwent initial CTA in the emergency department. In 126 (23.0%) patients, ipsilateral vascular findings were identified from which 40 (7.3%) needed treatment. The ABCD2-, ABCD3- and SPI-II-scores were not predictive for ipsilateral vascular pathologies. We identified male sex (OR 1.58, 1.06-2.36 95% CI; p=0.026), coronary heart disease (OR 1.88, 1.17-3.02 95% CI; p=0.009) and short duration of symptoms (OR 0.7, 0.55-0,89 95% CI; p=0.004) as predictors for ipsilateral vascular pathologies. ConclusionMore than every fifth TIA-patient had relevant vascular findings revealed by acute CTA. TIA-scores were not predictive for these findings. Male patients with a history of coronary heart disease and short duration of symptoms most likely might benefit from acute CTA to streamline further diagnostics and therapy.

Background Transient ischemic attack (TIA) is an important predictor for a pending stroke. Guidelines recommend similar workup for TIA-patients as for stroke patients to directly assess the extra- and intracranial arteries via Computed tomography angiography (CTA) regarding vascular pathologies with direct therapeutic implications. Aim of our study was a systematic analysis of CTA-findings in TIA-patients and evaluate possible predictive TIA scores for ipsilateral vascular pathology. Methods We analysed data from TIA patients, admitted to our University Medical Centre, between September 2015 and March 2018, to identify predictors for high-risk vascular pathologies, like high-grade stenosis, dissection, thrombi or occlusion and the for need for an intervention. Following subgroups were identified: 1) no- or low-grade-stenosis (<50%) 2) ipsilateral high-risk vascular pathology and 3) high risk findings needing surgical or interventional treatment. As predictive tools for ipsilateral vascular findings we used the ABCD2-, the ABCD3- and the SPI-II score.Results Of 833 patients, 549 (65.9%) underwent initial CTA in the emergency department. In 126 (23.0%) patients, ipsilateral vascular findings were identified from which 40 (7.3%) needed treatment. The ABCD2-, ABCD3- and SPI-II-scores were not predictive for ipsilateral vascular pathologies. We identified coronary heart disease (OR 2.13, 1.35-3.39 95% CI; p=0.001) and short duration of symptoms (OR 0.7, 0.55-0,89 95% CI; p=0.004) as predictors for ipsilateral vascular pathologies. Conclusion More than every fifth TIA-patient had relevant vascular findings revealed by acute CTA. TIA-scores were not predictive for these findings. Patients with a history of coronary heart disease and short duration of symptoms most likely might benefit from acute CTA to streamline further diagnostics and therapy.

BackgroundTransient ischemic attack (TIA) is an important predictor for a pending stroke. Guidelines recommend similar workup for TIA-patients as for stroke patients to directly assess the extra- and intracranial arteries via Computed tomography angiography (CTA) regarding vascular pathologies with direct therapeutic implications. Aim of our study was a systematic analysis of CTA-findings in TIA-patients and evaluate possible predictive TIA scores for ipsilateral vascular pathology. MethodsWe analysed data from TIA patients, admitted to our University Medical Centre, between September 2015 and March 2018, to identify predictors for high-risk vascular pathologies, like high-grade stenosis, dissection, thrombi or occlusion and the for need for an intervention. Following subgroups were identified: 1) no- or low-grade-stenosis (<50%) 2) ipsilateral high-risk vascular pathology and 3) high risk findings needing surgical or interventional treatment. As predictive tools for ipsilateral vascular findings we used the ABCD2-, the ABCD3- and the SPI-II score.ResultsOf 833 patients, 549 (65.9%) underwent initial CTA in the emergency department. In 126 (23.0%) patients, ipsilateral vascular findings were identified from which 40 (7.3%) needed treatment. The ABCD2-, ABCD3- and SPI-II-scores were not predictive for ipsilateral vascular pathologies. We identified coronary heart disease (OR 2.13, 1.35-3.39 95% CI; p=0.001) and short duration of symptoms (OR 0.7, 0.55-0,89 95% CI; p=0.004) as predictors for ipsilateral vascular pathologies. ConclusionMore than every fifth TIA-patient had relevant vascular findings revealed by acute CTA. TIA-scores were not predictive for these findings. Patients with a history of coronary heart disease and short duration of symptoms most likely might benefit from acute CTA to streamline further diagnostics and therapy.