Relative Analysis Between Transient Ischemic Attacks And Cerebral Infarction Displaying Transient Ischemic Attacks

Objective:The purpose of this study was to analyze clinical featuresbetween transient ischemic attacks and cerebral infarction displaying transientischemic attacks，to explore the relative clinical factors.Methods:A retrospeetive analysis was performed on83patients entered inneurology department of our hospital during2010.1-2012.2who were clinicallydiagnosed as TIA.all patients underwent MRI and DWI scan<24hours aftersymptoms onset. TCD and neck arterial color dopplar ultrasound or(and) CTAwere performed within1week after symptoms onset.A detailed history of TIApatients was investigated record clinical data and results of every assistedexamination.We separate the TIA patienis to two parts：with or without DWIabnormalities,to identify the positive rate of DWI abnormalities.We comparedthe risk factors,clinical symptoms,likely etiology,assisted examinations andprognosis(7days) of the two part TIA patients. Compare the distribution,degreeof intra and extra-cranial artery stenosis,analyze the distribution,type ofatheromatous plaque.Statistical analysis were performed with the spssstatistical package(13.0),Quantitative data was analyzed by independent-sample t-test,chi-square test or rank sum test.The results were regarded assignificance when p＜0.05.Results:(1)30out of83TIA patients (36.1%) revealed focal abno-rmalities on DWI;24out of50cases with carotid system TIA (48.0%) werefound acute ischemic lesions on DWI;6out of33cases with vertebrobasilarsystemTIA18.2%) were found acute ischemic lesions on DWI. There wasdifference between the two groups (χ2=7.65， p=0.006).（2） The risk factors:age,sex,blood pressure,history of ischemic heart disease, diabetesmellitus,atrial fibrillation,history of ischemic cerebrovascular disease,smoke,hyperlip-emia, fibrinogen,do not relate to the positive rate of DWI.(3) Theclinical features:the duration of symptoms,limb weakness, speech impairment,sensory disturbance, facial paralysis, hemianopsia, syncope, iplopia,dizziness,dystaxia, onset fall, tinnitus and the frequency of TIA before examination ofDWI do not relate to the positive rate of DWI.(4)The large arteryatherosclerosis is relate to the positive rate of DWI(p=0.03).The number ofatheromatous plaque in large artery atherosclerosis is relate to the positive rateof DWI(p=0.04).The type of atheromatous plaque is not relate to the positiverate of DWI(p=0.23).The intracranial and cervical angiostegnosis are not relateto the positive rate of DWI(color Doppler sonography:p=0.99,CTA:p=0.41).The distribution of atheromatous plaque in intracranial and cervical large arteryis not relate to the positive rate of DWI.(5) Within7days after TIAoutbreaks,The prognosis of DWI+(30.0%) is higher than DWI-(22.6)，there are5(16.7%) patients display repetitious TIA in DWI+,4(13.3%) patientsdeveloping into persisting clinical symptoms;however, there are12(22.6%)patients display repetitious TIA in DWI-,there is no patients developing intopersisting clinical symptoms,the type of ischemic cerebrovascular diseasewithin7days after TIA outbreaking displays statistical significance(p=0.006).Conclusions:(1) More than l/3patients displaying TIA had DWIabnormalities,it has already formed the cerebral infarction,the internal carotidartery system is more than vertebrobasilar arteries system.(2) There is nostatistical significance in the risk factors,clinical symptoms between DWI+andDWI-.(3) The large artery atherosclerosis is relate to positive of DWI, the moreatheromatous plaque,the more positive frequency of DWI,The type ofatheromatous plaque,the intracranial and cervical angiostegnosis,thedistribution of atheromatous plaque in intracranial and cervical large artery are no relate to DWI+.(4) Imformations from DWI were useful in estimatingprognosis,it relates to the type of ischemic cerebrovascular disease.The patientof DWI+are more likely to develop into persisting clinical symptoms within7days.(5) Traditional definition can not distinguish whether ot not happenhistologic damage,more accurate examination depends on MRI including DWI.There is no relation in the risk factors,clinical symptoms between DWI+andDWI-.The examination of DWI is essential for TIA patients...