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Peter J. Koudstaal, MD; Jan van Gijn, MD; Jan Lodder, MD; Cor W. G. M. Frenken, MD; Marinus Vermeulen, MD; Cees L. Franke, MD; Albert Hijdra, MD; Carel Bulens, MD; Dutch Transient Ischemic Attack Study Group

Arch Neurol. 1991;48(9):916-920.

Abstract
• We prospectively studied clinical and computed tomographic (CT) scan findings in 79 patients with a transient ischemic attack (TIA) and a relevant cerebral infarction on CT, also known as cerebral infarction with transient signs (CITS). We compared the results with those of 527 concurrent patients with TIA and without cerebral infarction and also with 646 patients with persistent neurological symptoms and a relevant infarct on CT. All patients were participating in a multi-center trial. In both groups, most infarcts were of the lacunar type. Compared with TIAs without cerebral infarction, patients with CITS slightly more often had a history of hypertension (52% vs 33%), the attacks lasted longer (>1 hour, 52% vs 34%) and disappeared more slowly (over the course of hours, 39% vs 24%), and the symptoms more frequently involved speech (61% vs 41%). Despite these small differences, the reverse—the prediction of evidence on CT of infarction on the basis of the nature or time course of symptoms—proved impossible, since in each category the majority of patients had a normal CT scan. In comparison with patients with stroke and visible infarction, patients with CITS slightly more often had abnormal speech (61% vs 45%) and had a larger number of attacks (multiple attacks, 46% vs 18%). In conclusion, we found only minor clinical differences between patients with TIA with or without a relevant infarct on CT and equally small differences between patients with CITS and patients with stroke and cerebral infarction. These clinical similarities do not exclude a difference in prognosis.

Author Affiliations
From the Departments of Neurology, University Hospital, Rotterdam (Drs Koudstaal and Vermeulen); University Hospital, Utrecht (Dr van Gijn); University Hospital, Maastricht (Dr Lodder); Catharina-Wilhelmina Hospital, Nijmegen (Dr Frenken); De Wever Hospital, Heerlen (Dr Franke); University of Amsterdam (Dr Hijdra); and Sint Fransiscus Hospital, Rotterdam (Dr Bulens), the Netherlands.

Footnotes
Accepted for publication January 31, 1991.

Reprint requests to University Hospital, Rotterdam Dijkzigt, 40 Dr Molewaterplein, 3015 GD Rotterdam, the Netherlands (Dr Koudstaal).

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