Minor Stroke and Transient Ischemic Attack: Research and Practice

Abstract

A majority of patients with ischemic stroke present with mild deficits for which aggressive management is not often pursued. Comprehensive work-up and appropriate intervention for minor strokes and transient ischemic attacks (TIAs) point toward better patient outcomes, lower costs, and fewer cases of disability. Imaging is a key modality to guide treatment and predict stroke recurrence. Patients with large vessel occlusions have been found to suffer worse outcomes and could benefit from intervention. Whether intravenous thrombolytic therapy decreases disability in minor stroke patients and whether acute endovascular intervention improves functional outcomes in patients with minor stroke and known large vessel occlusion remain controversial. Studies are ongoing to determine ideal antiplatelet therapy for stroke and TIA, while ongoing statin therapy, surgical management for patients with carotid stenosis, and anticoagulation for patients with atrial fibrillation have all been proven to decrease the rate of stroke recurrence and improve outcomes. This review summarizes the current evidence and discusses the standard of care for patients with minor stroke and TIA.

The Prognostic Value of Serum Cytokines in Patients with Acute Ischemic Stroke

“…The National Institutes of Health Stroke Scale (NIHSS) score was used to measure the severity of AIS patients by the neurologist within 24 hrs of admission and discharge [28, 29]. The minor stroke was defined as NIHSS score < 5 according to previous studies [30, 31]. The short-term functional outcome was assessed by telephone interviews or outpatient service at 3 months after stroke onset using the modified Rankin scale (mRS, scores range from 0 to 6) [32].…”

Cognitive and Emotional Impairment after Minor Stroke and Non-ST-Elevation Myocardial Infarction (NSTEMI): A Prevalence Study

“…Assessment of cognitive dysfunction and emotional symptoms is not routinely performed during follow-up and knowledge of the long-term impact of cognitive and emotional symptoms is sparse [3, 5], but attention to this issue is growing [13, 14]. There is no consensus on diagnostic criteria for minor stroke [15–19] which hampers research on this topic. There is consequently a need for studies investigating the consequences of cognitive and emotional impairment of minor strokes.…”

Characterization and Functional Assessment of Endothelial Progenitor Cells in Ischemic Stroke Patients

“…Although both ischemic stroke and TIA patients were recruited in the study, TIA patients only accounted for a minority in the stroke group (24 out of 207 patients), and both patient groups were diagnosed and managed in a similar manner [ 34 ]. Moreover, the amount of EPCs, early and late EPCs did not show any statistically significant difference between ischemic stroke and TIA patients (Supplementary Fig.…”

“…7C), and the correlation of diabetes mellitus with M12 EPC, no significant differences were observed in the EPC subpopulations measured by flow cytometry between the presence and absence of those risk factors. Although both ischemic stroke and TIA patients were recruited in the study, TIA patients only accounted for a minority in the stroke group (24 out of 207 patients), and both patient groups were diagnosed and managed in a similar manner [34]. Moreover, the amount of EPCs, early and late EPCs did not show any statistically significant difference between ischemic stroke and TIA patients ( Supplementary Fig.…”