Transient Ischemic Attack — Proposed New Definition

Brown, Martin M.; Rudd, Anthony; McGovern, Rory

doi:10.1056/nejm200304173481621

Cited by 12 publications

(1 citation statement)

References 6 publications

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“…Following the interview, any cases suspected to have had stroke or TIA were examined and confirmed by a vascular neurologist on site (Area II). Stroke and TIA were defined using published criteria[15,16] Anthropometric measurements and random blood glucose levels using Abbott MediSense Optium Glucose Monitor were recorded in all participants. All instruments used for anthropometric measurements were calibrated on a daily basis.…”

Section: Methodsmentioning

confidence: 99%

The burden of stroke and transient ischemic attack in Pakistan: a community-based prevalence study

et al. 2009

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BackgroundThe burden of cerebrovascular disease in developing countries is rising sharply. The prevalence of established risk factors of stroke is exceptionally high in Pakistan. However, there is limited data on the burden of stroke and transient ischemic attack (TIA) in South Asia. We report the first such study conducted in an urban slum of Karachi, Pakistan.MethodsIndividuals 35 years of age or older were invited for participation in this investigation through simple random sampling. A structured face-to-face interview was conducted using a pre-tested stroke symptom questionnaire in each participant to screen for past stroke or TIA followed by neurological examination of suspected cases. Anthropometric measurements and random blood glucose levels were recorded. Multivariable logistic regression was used to determine the association of vascular risk factors with prevalence of stroke.ResultsFive hundred and forty five individuals (49.4% females) participated in the study with a response rate of 90.8%. One hundred and four individuals (19.1%) were observed to have a prior stroke while TIA was found in 53 individuals (9.7%). Overall, 119 individuals (21.8% with 66.4% females) had stroke and/or TIA. Female gender, old age, raised random blood glucose level and use of chewable tobacco were significantly associated with the prevalence of cerebrovascular disease.ConclusionThis is the first study demonstrating an alarmingly high life-time prevalence of cerebrovascular disease in Pakistan. Individual and public health interventions in Pakistan to increase awareness about stroke, its prevention and therapy are warranted.

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Section: Methodsmentioning

confidence: 99%

The burden of stroke and transient ischemic attack in Pakistan: a community-based prevalence study

et al. 2009

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The release of tumor necrosis factor–α is associated with ischemic tolerance in human stroke

Castillo

Moro

Blanco

et al. 2003

Annals of Neurology

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Tumor necrosis factor (TNF)-alpha overexpression has been related to experimental ischemic tolerance when transient ischemia precedes cerebral infarction. We investigated TNF-alpha and interleukin (IL)-6 plasma concentrations in 283 patients with an acute stroke within 24 hours after symptom onset. An ipsilateral transient ischemic attack (TIA) within 72 hours before stroke was recorded in 38 patients. The infarct volume measured on computed tomography on days 4 to 7 and the frequency of poor outcome (Barthel Index score < 85) at 3 months were significantly lower in patients with prior TIA. Plasma concentrations of TNF-alpha were higher (42.5 +/- 9.9 vs 13.1 +/- 6.4pg/ml, p < 0.0001) and IL-6 levels were lower (10.1 +/- 6.2 vs 28.3 +/- 17.3pg/ml, p < 0.0001) in patients with prior TIA. A new variable termed TNF-alpha/IL-6 index was considered positive when TNF-alpha was greater than 30pg/ml and IL-6 was less than 30pg/ml. Positive TNF-alpha/IL-6 index was found in 92% of patients with prior TIA and in 1% of those without. TNF-alpha/IL-6 index (p = 0.0003) and TIA (p = 0.0001) were associated with good outcome in logistic regression analysis after adjusting for potential confounding factors. Ischemic tolerance in acute stroke is associated with increased plasma levels of TNF-alpha in the presence of reduced concentrations of IL-6.

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Transient ischemic attack may present a target for normobaric hyperoxia treatment

Hadjiev

Mineva

2010

Medical Hypotheses

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Transient Ischemic Attack — Proposed New Definition

Cited by 12 publications

References 6 publications

The burden of stroke and transient ischemic attack in Pakistan: a community-based prevalence study

The burden of stroke and transient ischemic attack in Pakistan: a community-based prevalence study

The release of tumor necrosis factor–α is associated with ischemic tolerance in human stroke

Transient ischemic attack may present a target for normobaric hyperoxia treatment

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