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
Feb 1, 1992·Neurology·S J KittnerL R Caplan
Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Jun 1, 1991·Neurology·J BogousslavskyL Kappenberger
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
Dec 12, 2001·Stroke; a Journal of Cerebral Circulation·P L Kolominsky-RabasP U Heuschmann
Nov 22, 2002·The New England Journal of Medicine·Gregory W AlbersUNKNOWN TIA Working Group
Jul 10, 2003·Lancet Neurology·José M Ferro
Feb 28, 2004·Stroke; a Journal of Cerebral Circulation·Robert G HartPeter J Koudstaal
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 30, 2007·Lancet·S Claiborne JohnstonStephen Sidney
Jan 1, 1997·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·M HoffmannT K Tatemichi
Sep 29, 2007·Stroke; a Journal of Cerebral Circulation·Joy LiaoMartin O'Donnell
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
Dec 22, 2010·Circulation·L Samuel WannUNKNOWN ACCF/AHA Task Force Members
Feb 16, 2011·Circulation·L Samuel WannUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force
Jun 8, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Jeffrey J PerryIan G Stiell
Apr 26, 2013·Cerebrovascular Diseases·Th F M FennisP J Koehler