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Early Stroke Risk High After Transient Ischemic Attack

Combination of transient ischemic attack and intracranial atherosclerosis put patients at high risk

FRIDAY, June 13 (HealthDay News) -- Patients who have recently had a transient ischemic attack (TIA) and intracranial atherosclerosis are at high risk of having a subsequent stroke in the region of the blocked artery within 90 days, researchers report in the June issue of the Archives of Neurology.

Bruce Ovbiagele, M.D., from the University of California Los Angeles, and colleagues determined the cumulative 90-day risk of ischemic stroke in the territory of the symptomatic artery in patients who had a TIA or a non-disabling stroke in the preceding three months and at least 50 percent stenosis of a major intracranial artery.

The researchers found that the 90-day risk was not significantly different after TIA or stroke (6.9 versus 4.7 percent). Significantly more of the strokes occurring in the arterial territory after TIA alone compared with stroke alone occurred in the first 90 days (60 versus 34.4 percent). In patients with TIA, a cerebral infarct on baseline neuroimaging was a significant predictor of early stroke (hazard ratio, 4.7), the report indicates.

"These data highlight the importance of prompt diagnosis and management of intracranial stenosis in patients with TIA, particularly those with cerebral infarction on brain imaging," Ovbiagele and colleagues write.

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