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22. European Stroke Conference 2 Acute cerebrovascular events (ACE): TIA and minor strokes 8:40 - 8:50 Signification of transient isolated visual symptoms in a large cohort of TIA patients. The SOS TIA Registry. P.C. Lavallée1, L Cabrejo2, J Labreuche3, M Mazighi4, E Meseguer5, I.F. Klein6, C Guidoux7, P Amarenco8 INSERM U-698, department of neurology and stroke center, AP-HP, Bichat-Claude Bernard Hospital, Univ Paris Diderot, Sorbonne Paris Cité, F-75018, Paris, FRANCE1,INSERM U-698, department of neurology and stroke center, AP-HP, Bichat-Claude Bernard Hospital, Univ Paris Diderot, Sorbonne Paris Cité, F-75018,, Paris, FRANCE2, IN-SERM U-698, department of neurology and stroke center, AP-HP, Bichat-Claude Bernard Hos-pital, Univ Paris Diderot, Sorbonne Paris Cité, F-75018,, Paris, FRANCE3, INSERM U-698, department of neurology and stroke center, AP-HP, Bichat-Claude Bernard Hospital, Univ Par-is Diderot, Sorbonne Paris Cité, F-75018,, Paris, FRANCE4, INSERM U-698, department of neurology and stroke center, AP-HP, Bichat-Claude Bernard Hospital, Univ Paris Diderot, Sor-bonne Paris Cité, F-75018,, Paris, FRANCE5, INSERM U-698, department of radiology, AP-HP, Bichat-Claude Bernard Hospital, Univ Paris Diderot, Sorbonne Paris Cité, F-75018,, Paris, FRANCE6, INSERM U-698, department of neurology and stroke center, AP-HP, Bichat-Claude Bernard Hospital, Univ Paris Diderot, Sorbonne Paris Cité, F-75018,, Paris, FRANCE7, IN-SERM U-698, department of neurology and stroke center, AP-HP, Bichat-Claude Bernard Hos-pital, Univ Paris Diderot, Sorbonne Paris Cité, F-75018,, Paris, FRANCE8 Background: Transient visual symptoms (TVS) are common complaints. They can be related to transient ischemic attack (TIA) but the nature of symptoms remains often uncertain and data on prognosis are scarce. We aimed to determine the diagnostic findings associated with TVS. Methods: Any suspicion of TIA admitted in the SOS-TIA clinic between January 2003 and De-cember 2008 had, immediate evaluation and treatment. We studied prevalence, presentation and impact of different types of TVS, with particular attention to the association with pathology at high risk of embolism. Results:Among 2398 patients admitted to the clinic, 826 (34.5%) had TVS including 422 (17.6%) with isolated TVS. Among 826 patients with TVS, a diagnosis of TIA (definite or pos-sible) or minor stroke was confirmed in 72%. Among 1850 patients with a diagnosis of TIA or minor stroke, transient monocular blindness (TMB) was the most frequent TVS (15.1%), fol-lowing by diplopia (5.0%), homonymous lateral hemianopia (HLH, 3.7%), bilateral positive visual phenomena (1.6%), lone bilateral blindness (LBB) (0.9%). Major source of embolism of cardiac or arterial origin was less frequently found in patients with isolated and non isolat-ed TVS than in patients without TVS (19.6%,19.7% and 28.1 %, respectively, adjusted OR 0,77;95%CI 0,60-1; p<0,001). However, we found a higher rate of atrial fibrillation (AF) in patients with HLH (23.2%) than in patients with other TVS (4.0%, adjusted OR, 6.71; 95%CI, 2.99-15.06) or with non-visual symptoms (9.1%, adjusted OR, 4.39; 95%CI, 2.26-8.50). Ex-tra- cranial large artery atherosclerosis was the main cause of TMB, while for the other TVS, the different major source of emboli were equally represented. Positive diffusion was found in re-spectively 12, 8, 8 and 5 % of patients with HLH, diplopia, LBB and TMB. Conclusion: One out of 5 of patients with TVS had a major source of embolism detected requir-ing urgent management. AF is particularly frequent in patients with transient HLH. 8:30-10:00 Oral Session Room 17 Acute cerebrovascular events (ACE): TIA and minor strokes Chairs: P. Canhao, Portugal and J. Harbison, Ireland 1 Acute cerebrovascular events (ACE): TIA and minor strokes 8:30 - 8:40 Non-focal neurological symptoms do not affect the long-term prognosis of patients with a TIA or minor ischaemic stroke A. Compter1, H.B. van der Worp2, L.J. Kappelle3, J. van Gijn4, P.J. Koudstaal5, A. Algra6 University Medical Center Utrecht and Rudolf Magnus Institute of Neuroscience, Utrecht, THE NETHERLANDS1,University Medical Center Utrecht, Utrecht, THE NETHERLANDS2, University Medical Center Utrecht, Utrecht, THE NETHERLANDS3, University Medical Cen-ter Utrecht, Utrecht, THE NETHERLANDS4, Erasmus Medical Center Rotterdam, Rotterdam, THE NETHERLANDS5, University Medical Center Utrecht, Utrecht, THE NETHERLANDS6 Background: In patients with a TIA or minor ischaemic stroke, focal neurological symptoms are often accompanied by atypical, non-focal symptoms such as confusion and non-rotatory dizzi-ness. Some studies have suggested that non-focal symptoms may be associated with a higher risk of major vascular disease. We assessed the relationship between the occurrence of non-fo-cal symptoms and vascular events and long-term survival in patients with a TIA or minor isch-aemic stroke. Methods: We studied 2409 patients with a TIA (n=723) or minor ischaemic stroke (n=1686) in-cluded in the Life Long After Cerebral Ischemia cohort that was based on the Dutch TIA Trial. All patients underwent a standardised questionnaire on the occurrence of focal and non-focal neurological symptoms during the qualifying event. The primary outcome was the composite of vascular death, non-fatal cardiac event, or non-fatal stroke. Secondary outcome measures were all-cause death, vascular death, cardiac death, non-fatal cardiac event, or non-fatal stroke. Hazard Ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated for the occurrence of outcome events by univariable and multivariable Cox proportional regression analyses. Results: Focal symptoms were accompanied by non-focal symptoms in 739 (31%) of the 2409 patients. After a mean follow-up of 10.1 years, 1313 (55%) patients had at least one vascular event and 1458 (61%) patients had died. During this period the risk of the primary outcome was the same in patients with both focal and non-focal symptoms and in patients with focal symp-toms only (adjusted HR, 0.97; 95% CI, 0.86-1.09). The risk of each of the secondary outcome measures was also similar in both groups. Conclusion: About one third of the patients with a TIA or minor ischaemic stroke has both focal and non-focal neurological symptoms. In contrast to previous studies, patients with non-focal symptoms had no increased risk of poor prognosis on the long-term. 100 © 2013 S. Karger AG, Basel Scientific Programme


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