Abstract
Transient ischemic attacks (TIAs) are brief reversible episodes of neurological dysfunction due to temporary focal cerebral ischemia. Angiography should be performed only when operation is indicated or when the diagnosis is in doubt. Surgical treatment is recommended when the patient is a good surgical risk, when the stenosis is more than 70 per cent in the appropriate vessel and in certain patients with less severe stenotic lesions that appear to be a probable source of emboli. Anticoagulant therapy is indicated when there are recurrent TIAs, when the patient is not a good surgical candidate and when no appropriate surgically remediable lesion is found by angiography. If there is any significant contraindication to anticoagulants they should not be given. Discontinuance of anticoagulant therapy when the patient has been symptom-free for six months is recommended. In the experience of the authors the TIA syndrome is more benign in its course than was originally suspected and a conservative approach to surgical and anticoagulant therapy is recommended.
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Selected References
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- BRICE J. G., DOWSETT D. J., LOWE R. D. HAEMODYNAMIC EFFECTS OF CAROTID ARTERY STENOSIS. Br Med J. 1964 Nov 28;2(5421):1363–1366. doi: 10.1136/bmj.2.5421.1363. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burrows E. H., Marshall J. Angiographic investigation of patients with transient ischaemic attacks. J Neurol Neurosurg Psychiatry. 1965 Dec;28(6):533–539. doi: 10.1136/jnnp.28.6.533. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DEBAKEY M. E., CRAWFORD E. S., COOLEY D. A., MORRIS G. C., Jr, GARRET H. E., FIELDS W. S. CEREBRAL ARTERIAL INSUFFICIENCY: ONE TO 11-YEAR RESULTS FOLLOWING ARTERIAL RECONSTRUCTIVE OPERATION. Ann Surg. 1965 Jun;161:921–945. doi: 10.1097/00000658-196506000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
- FARIS A. A., POSER C. M., WILMORE D. W., AGNEW C. H. Radiologic visualization of neck vessels in healthy men. Neurology. 1963 May;13:386–396. doi: 10.1212/wnl.13.5.386. [DOI] [PubMed] [Google Scholar]
- FISHER C. M. Observations of the fundus oculi in transient monocular blindness. Neurology. 1959 May;9(5):333–347. doi: 10.1212/wnl.9.5.333. [DOI] [PubMed] [Google Scholar]
- FISHER M. Occlusion of the internal carotid artery. AMA Arch Neurol Psychiatry. 1951 Mar;65(3):346–377. doi: 10.1001/archneurpsyc.1951.02320030083009. [DOI] [PubMed] [Google Scholar]
- MARSHALL J. THE NATURAL HISTORY OF TRANSIENT ISCHAEMIC CEREBRO-VASCULAR ATTACKS. Q J Med. 1964 Jul;33:309–324. [PubMed] [Google Scholar]
- Rainer W. G., Feiler E. M., Bloomquist C. D., McCrory C. B. Surgical approach to carotid arterial insufficiency. Risks and results. Ann Thorac Surg. 1966 Sep;2(5):640–648. doi: 10.1016/s0003-4975(10)66633-7. [DOI] [PubMed] [Google Scholar]
- SCHWARTZ C. J., MITCHELL J. R. Atheroma of the carotid and vertebral arterial systems. Br Med J. 1961 Oct 21;2(5259):1057–1063. doi: 10.1136/bmj.2.5259.1057. [DOI] [PMC free article] [PubMed] [Google Scholar]
- YOUNG J. R., HUMPHRIES A. W., DEWOLFE V. G., BEVEN E. G., LEFEVRE F. A. EXTRACRANIAL CEREBROVASCULAR DISEASE TREATED SURGICALLY; STUDY OF 100 PATIENTS. Arch Surg. 1964 Nov;89:848–855. doi: 10.1001/archsurg.1964.01320050094008. [DOI] [PubMed] [Google Scholar]
