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A Prospective Study of 160 Patients

James F. Toole, MD; Richard Janeway, MD; Kwan Choi, MD; Robert Cordell, MD; Courtland Davis, MD; Frank Johnston, MD; Henry S. Miller, MD

Arch Neurol. 1975;32(1):5-12.

Abstract
Patients with transient ischemic attacks (TIAs) due to atherosclerosis were studied by aortocranial arteriography. Onset of TIAs was before age 55 in 24% and between 55 and 64 in 47%. Men exceeded women by two to one. Of 160 patients, 77 were treated medically and 82 surgically. Five died in the immediate postoperative period. In the survivors, mortality has been the same in the medically and surgically managed groups. For patients with multiple lesions, surgical reconstruction of the carotid arteries was associated with very high surgical risk. In the medically treated group, anticoagulant therapy reduced the frequency of TIAs, but did not appear to protect patients from stroke. Mortality was 23% at four years, 57% of deaths being attributable to myocardial infarction and 38% to stroke.

Author Affiliations
From the departments of neurology (Drs. Toole, Choi, and Janeway), surgery (Drs. Cordell, Johnston, and Davis), medicine (Dr. Miller), and the Office of the Dean (Dr. Janeway), Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC.

Footnotes
Accepted for publication May 6, 1974.

Reprint requests to Department of Neurology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103 (Dr. Toole).

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