The duration of symptoms in transient ischemic attack

Neurology. 1999 Mar 23;52(5):976-80. doi: 10.1212/wnl.52.5.976.

Abstract

Background: The majority of TIAs last from 2 to 15 minutes, although some may be of long duration.

Objective: We examined factors related to the duration of TIAs to identify the relationship to clinical characteristics.

Methods: We performed brain imaging studies as well as angiographic and cardiac examinations in 81 consecutive patients (64 men and 17 women, age 65.8+/-9.9 years) with carotid TIAs. We evaluated risk factors (hypertension, diabetes mellitus, hyperlipidemia, alcohol consumption, and smoking), potential cardiac sources of emboli, and arterial stenosis > or =50% in diameter in the carotid or middle cerebral arteries. Recent infarcts were assessed with CT or MRI. We correlated duration of symptoms with clinical data.

Results: The presence of emboligenic cardiac or arterial diseases was significantly related to the duration of symptoms. With sensitivity-specificity curve analysis for detecting such diseases, the duration of symptoms could be divided into short-duration TIAs (<60 minutes, n = 41) or long-duration TIAs (> or =60 minutes, n = 40). Patients with long-duration TIAs had emboligenic cardiac or arterial diseases more frequently than those with short-duration TIAs (86% versus 46%, p < 0.001). Recent infarcts were also more frequent in patients with long-duration TIAs than they were in patients with short-duration TIAs (45% versus 21%, p < 0.05).

Conclusions: Short-duration and long-duration TIAs can be separated based on symptom duration of < 1 hour or > or = 1 hour. Patients with long-duration TIAs should be examined more closely for the presence of cardiac and arterial diseases than those with short-duration TIAs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cerebral Infarction / complications
  • Female
  • Humans
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / physiopathology*
  • Male
  • Middle Aged
  • Risk Factors
  • Time Factors