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A Related Clinical Study of Transient Ischemic Attack Developing into Cerebral Infarction

Author: PuZhe
Tutor: NanGuangXian
School: Yanbian University
Course: Internal Medicine
Keywords: Transient ischemic attack recurrent attacks cerebral infarction termination
CLC: R743.3
Type: Master's thesis
Year: 2011
Downloads: 72
Quote: 0
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Abstract

Objective:Transient ischemic attack (TIA) is the early warning signal of ischemic cerebrovascular disease, which is usually regarded as neurological emergency. Along with the continually increase of incidence of TIA and the probability of developing into cerebral infarction increases progressively, people pay more and more attention to TIA. In the past, people set the upper limit of attack time of TIA to twenty-four hours, however, along with a large number of clinical research and extensive use of accessory equipment such as TCD、CT、MRI、CTA、DSA, people find that traditional definition of TIA already has not corresponded with reality yet. Generally, via systemic therapy after admission, most patients with TIA disease are remission of clinical symptom, however, part patients still suffer from recurrent attacks. In the past, it is considered that one third patients with transient ischemic attack develop into cerebral infarction, one third patients subsided without medication, one third patients still suffer from recurrent attacks. However, it is discovered that the probability of TIA developing into cerebral infarction could significantly increase among patients with recurrent attacks of TIA. Through the research in this paper, we could discuss the etiological factors of TIA developing into cerebral infarction.Methods:In order to further research the transient ischemic attack of etiological factor, clinical manifestation, high risk factors and termination and to become more aware of transient ischemic attack, the subjects of the study are 120 patients with recurrent attacks of TIA from September 2008 to December 2010 at China-Japan Union Hospital of Jilin University and carry out the six-month follow-up to the following patient. Via follow-up, it is discovered that, among the patients with recurrent attacks of TIA, most patients have developed into cerebral infarction, part patients still suffer from recurrent attacks or remission of clinical symptom. This study divided patients into the group of infarction group(patients develop into cerebral infarction) and non-infarction group(patients did not develop into cerebral infarction).Through the comparison with gender, age, high risk factors, attack time and the grade of ABCD2 between two groups, we could carry out clinical research and discussion.Results:(1) Among the 120 follow-up patients,78 patients develop into cerebral infarction occupying 65%; the other 42 patients did not develop into cerebral infarction occupying 35%. (2) Among the patients with recurrent attacks of TIA, the principle etiological factor of patients developing into cerebral infarction are hypertension, diabetes and hemadostenosis. (3) It is easier to develop into cerebral infarction when TIA attack duration exceed thirty minutes. (4)The higher the grade of ABCD2 is, the higher developing into the cerebral infarction is.Conclusions:Most patients are persons in middle and old age with hazards of cerebrovascular disease, fifty to seventy year old are popular pathogenesis age; there is no obvious differentiae between male and female probability; patients with TIA who has high grade of ABCD2 easier develop into cerebral infarction; there is no obvious differentiae to develop into cerebral infarction between internal carotid artery system and vertebral-basilar artery system. The factors of easily developing into cerebral infarction have following points. (1) Aspect of etiological factors:Patients with TIA who have arteriosclerosis, arteriarctia and whose blood are in hypercoagulability more easily develop into cerebral infarction. (2) Aspect of symptoms: Patients with TIA who still have recurrent attacks or whose attack time exceed thirty minutes, after systemic therapy, more easily develop into cerebral infarction. (3) Aspect of hazards: Patients with TIA who have the high risk factors such as hypertension, diabetes, hemadostenosis etc more easily develop into cerebral infarction.

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