Introduction
Nonfocal transient neurological attacks (TNAs) are episodes with atypical,
nonlocalizing cerebral symptoms. We examined the prevalence of nonfocal
TNAs, in patients with and without carotid artery occlusion (CAO).
Methods
We included 67 patients with CAO and 62 patients without CAO. In both groups,
patients had a history of transient ischemic attack (TIA) or nondisabling
ischemic stroke in the anterior circulation that had occurred >6 months
before inclusion. Patients without CAO did not have ipsilateral or
contralateral carotid artery stenosis of ≥50%. All patients were interviewed
with a standardized questionnaire on the occurrence of nonfocal TNA symptoms
during the preceding six months. We calculated risk ratios (RRs) with 95%
confidence intervals (CIs) for the occurrence of ≥1 and ≥2 different
nonfocal TNAs after adjustments for age, sex, systolic blood pressure and
time interval between most recent TIA or ischemic stroke and administration
of the questionnaire.
Results
Forty-three of all patients (33%) had had one or more nonfocal TNAs in the
preceding six months. Nonrotatory dizziness (24%) was reported most often.
The prevalence of ≥1 nonfocal TNAs was not significantly different between
patients with and without CAO (39% vs. 27%; adjusted RR 1.47, 95% CI
0.83–2.61), but the prevalence of ≥2 or more different nonfocal TNAs was
higher in patients with CAO (16% vs. 3%; adjusted RR 4.77, 95% CI
1.20–18.98). In patients with CAO who also had a contralateral carotid or
vertebral artery steno-occlusion, nonfocal TNAs occurred more often than in
patients without any carotid or vertebral artery steno-occlusion (46% vs.
27%; adjusted RR 2.22, 95% CI 1.08–4.60 for ≥1 and 21% vs. 3%; adjusted RR
8.27, 95% CI 1.83–37.32 for ≥2 nonfocal TNAs).
Conclusions
Patients with CAO more often experienced multiple nonfocal TNAs than patients
without CAO.