Prediction and prevention of stroke after transient ischemic attack in the short and long term

Expert Review of Neurotherapeutics
Matthew F Giles, Peter M Rothwell

Abstract

Over the last 5 years, a number of studies have shown the early risk of stroke following transient ischemic attack (TIA) to be of the order of 5-10% at 1 week and 10-20% at 3 months, considerably higher than previously estimated. Because these studies have been carried out in a variety of different clinical settings, their findings are likely to be generalizable. Various independent prognostic factors for this early risk of stroke have been identified and models, based on clinical features at presentation, have been derived and validated to predict risk of stroke within 7 and 90 days after TIA. At the same time, diffusion-weighted magnetic resonance imaging and carotid imaging provide prognostic information and are likely to refine risk prediction further, although no unified model combining clinical and imaging data currently exists. Uncertainty continues surrounding the most effective secondary prevention in the hyperacute phase after TIA, especially in the choice of antiplatelet agents, although clinical trials to address this question are ongoing. However, the need for carotid endarterectomy in patients with symptomatic carotid stenosis is well established. The risk of vascular disease in the medium term (1-5 years) followi...Continue Reading

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Citations

Nov 13, 2007·Lancet Neurology·Matthew F Giles, Peter M Rothwell
Apr 20, 2016·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Yuan TianDavid B Matchar

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