Prognosis of patients with transient ischemic attacks and normal angiograms
D. S. Mendelowitz, S. Kimmins and W. E. Evans
Of 358 patients referred for evaluation of cerebral vascular insufficiency
over a ten-year period (January 1971 to April 1981), 32 were isolated who
had experienced hemispheric transient ischemic attacks (TIAs), and lacking
other identifiable abnormality were found angiographically to be free of
suspicious extracranial occlusive or ulcerated lesions. These patients were
studied retrospectively to evaluate their prognosis in terms of cerebral
infarction and recurrent neurologic symptoms. In a mean follow-up of 16
months, ranging from three months to four years, no patient suffered a
cerebral infarction. Six had further symptoms; however three were due to
other abnormalities found subsequently. Three patients continued to be
symptomatic; however, only one patient had recurrent hemispheric symptoms,
the others being global and vague in description. Severe hypertension was
associated with an increased risk of further attacks. The data indicate
that the prognosis for patients with normal angiograms and hemispheric
TIAs, lacking other identifiable abnormality, is good.
