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Academia Mexicana de Neurología, A.C.

2012, Number 1

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Rev Mex Neuroci 2012; 13 (1)

Diagnosis and prognosis of transient ischemic attack in a program of immediate attention

Infante-Valenzuela A, Góngora-Rivera F, Villarreal-Velázquez HJ

Language: Spanish
References: 20
Page: 22-29
PDF size: 218.86 Kb.


ABSTRACT

Introduction: Transient ischemic attack (TIA) is a syndrome characterized by focal neurologic deficit of vascular origin, self-limited in ‹ 24 h. Identifying the etiology and establishing opportune secondary prevention management diminish the risk of recurrence and of definite cerebral infarction. Objective: To describe the experience in diagnosis, management and prognosis of acute cerebrovascular syndromes in a system of immediate clinical attention, the SOS-AIT-HU program. Material and methods: In the first year of operations a total of 83 adults with clinical suspicion of TIA, referred from the Emergencyand Ambulatory Care Departments. ICT etiology was classified according to TOAST and A-S-C-O systems, and stratified according to ABCD2 and ABCD3+i. All patients received followup at 30 and 90 days. Results: A total of 49 (59%) cases not corresponding genuinely to TIA were identified, mainly metabolic and convulsive causes. A total of 34 (41%) cases were confirmed with TIA, with etiology according with TOAST as follows: 7 (20%) large-artery atherothrombosis, 5 (14%) cardioembolism, 15 (44%) small-vessel disease, 4 (12%) with other determined causes and 3 (9%) undetermined. The mean duration of hospital stay was 2.5 days and in 90% of patients the etiology was determined in ‹ 3 days. Eleven (35%) subjects had a lesion in DWI-MRI (minor infarction with spontaneous recovery ad integrum). Recurrence rate was 5% and 14% at 30 and 90 days, respectively. Conclusions: The SOS-AIT-HU program has increased the registering of patients with TIA and has defined better the mimicking cases. It has been reached a similar outcome compared with that of the international literature. As far as we know, the SOS-AITHU program is the first of its kind in Mexico.


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