Isolated transient aphasia at emergency presentation is associated with a high rate of cardioembolic embolism

CJEM
Jason WassermanMukul Sharma

Abstract

A cardiac source is often implicated in strokes where the deficit includes aphasia. However, less is known about the etiology of isolated aphasia during transient ischemic attack (TIA). Our objective was to determine whether patients with isolated aphasia are likely to have a cardioembolic etiology for their TIA. We prospectively studied a cohort of TIA patients in eight tertiary-care emergency departments. Patients with isolated aphasia were identified by the treating physician at the time of emergency department presentation. Patients with dysarthria (i.e., a phonation disturbance) were not included. Potential cardiac sources for embolism were defined as atrial fibrillation on history, electrocardiogram, Holter monitor, atrial fibrillation on echocardiography, or thrombus on echocardiography. Of the 2,360 TIA patients identified, 1,155 had neurological deficits at the time of the emergency physician assessment and were included in this analysis, and 41 had isolated aphasia as their only neurological deficit. Patients with isolated aphasia were older (73.9±10.0 v. 67.2±14.5 years; p=0.003), more likely to have a history of heart failure (9.8% v. 2.6%; p=0.027), and were twice as likely to have any cardiac source of embolism (2...Continue Reading

References

Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Jan 14, 1989·BMJ : British Medical Journal·P A SandercockI R Starkey
Dec 1, 1989·Stroke; a Journal of Cerebral Circulation·L E KnepperE E Marsh
Mar 20, 1999·Journal of Neurology, Neurosurgery, and Psychiatry·R E HanlonA W Dromerick
Jan 9, 2001·JAMA : the Journal of the American Medical Association·S C JohnstonS Sidney
Oct 6, 2001·Stroke; a Journal of Cerebral Circulation·W J JonesJ F Meschia
Nov 22, 2002·The New England Journal of Medicine·Gregory W AlbersUNKNOWN TIA Working Group
Jul 10, 2003·Lancet Neurology·José M Ferro
Mar 31, 2004·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·David J GladstoneJack V Tu
Apr 27, 2005·Annals of Neurology·Hakan AyA Gregory Sorensen
Jun 16, 2005·Archives of Neurology·Alexandre B MaulazJulien Bogousslavsky
Jan 1, 1997·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·M HoffmannT K Tatemichi
Oct 2, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Ross L LevineMuhammed Khasru
Oct 12, 2007·Lancet·Peter M RothwellUNKNOWN Early use of Existing Preventive Strategies for Stroke (EXPRESS) study
Oct 12, 2007·Lancet Neurology·Philippa C LavalléePierre Amarenco
Nov 6, 2008·Cerebrovascular Diseases·Shyam PrabhakaranVivien H Lee
Aug 24, 2010·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Luciano A SposatoAlejandro Rabinstein
Oct 16, 2010·Stroke; a Journal of Cerebral Circulation·Jason WassermanMukul Sharma
Jun 8, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Jeffrey J PerryIan G Stiell

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Aphasia

Aphasia affects the ability to process language, including formulation and comprehension of language and speech, as well as the ability to read or write. Here is the latest research on aphasia.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.