Should We Treat a Patient's Symptoms or Angiography Image in
TIA? Two Case Reports

J 2016

Should We Treat a Patient's Symptoms or Angiography Image in TIA? Two Case Reports

KARPATOVÁ, Hana; Jana JANKOVÝCH a Robert MIKULÍK

Základní údaje

Originální název

Should We Treat a Patient's Symptoms or Angiography Image in TIA? Two Case Reports

Autoři

KARPATOVÁ, Hana; Jana JANKOVÝCH a Robert MIKULÍK

Vydání

Neurologist, Philadelphia, Lippincott Williams & Wilkins, 2016, 1074-7931

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 0.678

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/16:00092489

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

transient ischemic attack; middle cerebral artery occlusion; revascularization; outcome after transient ischemic attack

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 21. 12. 2016 15:41, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

Objectives: Data on vascular status in the first hours after onset of transient ischemic attack (TIA) and its clinical significance are missing. Also, it is not known whether arterial occlusion, if present in TIA, should be the target for revascularization. We present 2 patients to demonstrate that TIA can be due to acute major intracranial arterial occlusion and to show how such arterial occlusion may affect the outcome. Case reports: Two patients (54 and 63 years old) were diagnosed with TIA and at the same time had occlusion of the middle cerebral artery. No recanalization therapy was performed, as there was no or minimal neurological deficit. After several hours, the condition of both patients clinically deteriorated. One patient experienced spontaneous recanalization in the first 24 hours and clinical improvement over the subsequent days, resulting in complete resolution of the neurological deficit. The other patient did not recanalize and developed a significant brain infarction as well as hemorrhagic transformation requiring decompression surgery. Over the long term, the patient remained hemiplegic, unable to walk, and dependent on assistance for most activities of daily living. Conclusions: The cases presented here raise important questions: (1) How frequently is arterial occlusion present in clinically asymptomatic patients? (2) If occlusion is present but not symptoms, is stroke a more correct diagnosis than TIA? and (3) What would be the benefit of recanalization therapy? Studies addressing these questions should be conducted.

Citovat

KARPATOVÁ, Hana; Jana JANKOVÝCH a Robert MIKULÍK. Should We Treat a Patient's Symptoms or Angiography Image in TIA? Two Case Reports. Neurologist. Philadelphia: Lippincott Williams & Wilkins, 2016, roč. 21, č. 6, s. 87-90. ISSN 1074-7931. Dostupné z: https://doi.org/10.1097/NRL.0000000000000093.

@article{1365670,
   author = {Karpatová, Hana and Jankových, Jana and Mikulík, Robert},
   article_location = {Philadelphia},
   article_number = {6},
   doi = {https://doi.org/10.1097/NRL.0000000000000093},
   keywords = {transient ischemic attack; middle cerebral artery occlusion; revascularization; outcome after transient ischemic attack},
   language = {eng},
   issn = {1074-7931},
   journal = {Neurologist},
   title = {Should We Treat a Patient's Symptoms or Angiography Image in TIA? Two Case Reports},
   volume = {21},
   year = {2016}
}

TY  - JOUR
ID  - 1365670
AU  - Karpatová, Hana - Jankových, Jana - Mikulík, Robert
PY  - 2016
TI  - Should We Treat a Patient's Symptoms or Angiography Image in TIA? Two Case Reports
JF  - Neurologist
VL  - 21
IS  - 6
SP  - 87-90
EP  - 87-90
PB  - Lippincott Williams & Wilkins
SN  - 10747931
KW  - transient ischemic attack
KW  - middle cerebral artery occlusion
KW  - revascularization
KW  - outcome after transient ischemic attack
N2  - Objectives: Data on vascular status in the first hours after onset of transient ischemic attack (TIA) and its clinical significance are missing. Also, it is not known whether arterial occlusion, if present in TIA, should be the target for revascularization. We present 2 patients to demonstrate that TIA can be due to acute major intracranial arterial occlusion and to show how such arterial occlusion may affect the outcome. Case reports: Two patients (54 and 63 years old) were diagnosed with TIA and at the same time had occlusion of the middle cerebral artery. No recanalization therapy was performed, as there was no or minimal neurological deficit. After several hours, the condition of both patients clinically deteriorated. One patient experienced spontaneous recanalization in the first 24 hours and clinical improvement over the subsequent days, resulting in complete resolution of the neurological deficit. The other patient did not recanalize and developed a significant brain infarction as well as hemorrhagic transformation requiring decompression surgery. Over the long term, the patient remained hemiplegic, unable to walk, and dependent on assistance for most activities of daily living. Conclusions: The cases presented here raise important questions: (1) How frequently is arterial occlusion present in clinically asymptomatic patients? (2) If occlusion is present but not symptoms, is stroke a more correct diagnosis than TIA? and (3) What would be the benefit of recanalization therapy? Studies addressing these questions should be conducted.
ER  -

KARPATOVÁ, Hana; Jana JANKOVÝCH a Robert MIKULÍK. Should We Treat a Patient's Symptoms or Angiography Image in TIA? Two Case Reports. \textit{Neurologist}. Philadelphia: Lippincott Williams \&{} Wilkins, 2016, roč.~21, č.~6, s.~87-90. ISSN~1074-7931. Dostupné z: https://doi.org/10.1097/NRL.0000000000000093.

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