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Transient Neurological Attacks Predict Future Events

Focal, non-focal and mixed varieties' connection with major vascular disease and dementia examined

WEDNESDAY, Dec. 26 (HealthDay News) -- Transient neurological attacks (TNAs) with diffuse, non-localizing cerebral symptoms are risk factors for major vascular diseases and dementia, according to a report in the Dec. 26 issue of the Journal of the American Medical Association.

Michiel J. Bos, M.D., of the Erasmus Medical Center in Rotterdam, the Netherlands, and colleagues followed 6,062 participants in the Rotterdam Study, aged 55 and older, who were free of stroke, myocardial infarction and dementia at baseline in 1990-1993. They were followed for events until January 2005.

In both men and women, the incidence rate of non-focal TNAs were almost as frequent as focal TNAs, while mixed TNAs were less frequent (3.8, 4.7, and 0.6 per 1,000 person-years, respectively). While patients with focal TNAs had higher risk of stroke only, those with non-focal TNAs had higher risk of stroke and dementia than participants without TNAs. Participants with mixed TNAs were at increased risk of stroke, ischemic heart disease, vascular death and dementia than participants without TNAs.

An accompanying editorial concludes, "Even though TNA is likely to be only of transient utility because clinicians must quickly move to more specific diagnoses to provide appropriate treatment for patients, this entity should be considered a rally cry for more extensive evaluation or consultation in these patients, as well as for further research."

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