The neuroprotection of prodromal transient ischaemic attack on cerebral infarction

Background and purpose: To evaluate the potential neuroprotection against subsequent cerebral infarction conferred by a prodromal transient ischaemic attack (TIA).

Methods: Various measures, including blood pressure, blood serum glucose, serum lipids, cardiovascular imaging and changes to NIHSS scores were evaluated upon admission and discharge for patients presenting with ischaemic stroke with or without prodromal TIA (n = 60 per group).

Results: When all patients from each group were considered together, no significant group effects emerged. However, when the NIHSS difference scores from the prodromal TIA group were subdivided based on (i) prodromal TIA lasting up to 4 min; (ii) two prodromal TIA attacks and/or; (iii) prodromal TIA-stroke interval within 7 days separately, patients in subgroups 1 and 2 exhibited significantly better outcome on discharge. There was no significant effect found in subgroup three although this TIA group did show better outcome in considering the NIHSS changes.

Conclusions: Prodromal TIA prior to cerebral infarction may result in an ischaemic tolerance effect. Moreover, the neuroprotection conferred by the TIA may be associated with the duration and the frequency of the TIA, although the relationship between the TIA-stroke interval and prognosis is not clear.